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Europace 2007 9(1):76-77; doi:10.1093/europace/eul141
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

PACING

Unusual VDD-pacing

Jörg Schumann1, Stephanie Kiencke1, Stefan Osswald2 and Peter Rickenbacher1,*

1 Cardiology Division, Internal Medicine University Department, Kantonsspital Bruderholz, H-4101 Bruderholz, Switzerland; 2 Cardiology Division, University Hospital Basel, Switzerland

The case of an 80-year-old woman who underwent permanent VDD-pacemaker implantation for recurrent syncope in the presence of second-degree type 2 AV-block is reported. During follow-up, low atrial sensing with AV-synchrony of only 58–73% was noted. Four years after the pacemaker implantation, the patient was hospitalized for non-cardiac reasons and the chest radiograph showed displacement of the atrial dipole into the right ventricular outflow tract (RVOT). It is hypothesized that AV-synchrony was maintained by left atrial sensing due to the anatomic proximity of the RVOT to the left atrial appendage.

Key Words: VDD pacing, P-wave sensing, Atrial undersensing

* Corresponding author. Tel: +41 61 436 2220; fax: +41 61 436 3670. E-mail address: peter.rickenbacher{at}ksbh.ch


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