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Semergen. 2014 Apr;40(3):e57-9. doi: 10.1016/j.semerg.2013.02.001. Epub 2013 Jun 13.

[Wide QRS tachycardia preceded by pacemaker spikes].

[Article in Spanish]

Author information

1
Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España. Electronic address: manuel.romero.gonzalez.sspa@juntadeandalucia.es.
2
Servicio de Cardiología, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
3
Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.

Abstract

The differential diagnosis and therapeutic management of wide QRS tachycardia preceded by pacemaker spike is presented. The pacemaker-mediated tachycardia, tachycardia fibrillo-flutter in patients with pacemakers, and runaway pacemakers, have a similar surface electrocardiogram, but respond to different therapeutic measures. The tachycardia response to the application of a magnet over the pacemaker could help in the differential diagnosis, and in some cases will be therapeutic, as in the case of a tachycardia-mediated pacemaker. Although these conditions are diagnosed and treated in hospitals with catheterization laboratories using the application programmer over the pacemaker, patients presenting in primary care clinic and emergency forced us to make a diagnosis and treat the haemodynamically unstable patient prior to referral.

KEYWORDS:

Atrial fibrilation and pacemaker; Marcapasos malfuncionante o desbocado; Marcapasos y fibrilo-flutter auricular; Pacemaker-mediated tachycardia; Runaway pacemaker; Taquicardia mediada por marcapasos

PMID:
23768570
DOI:
10.1016/j.semerg.2013.02.001
[Indexed for MEDLINE]
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