PACEMAKER SYNDROME

Course overview

PACEMAKERS HAVE BECOME AN ESTABLISHED MODALITY FOR LONG-TERM MANAGEMENT OF LIFE-THREATENING ARRHYTHMIAS AND CAN SIGNIFICANTLY IMPROVE PATIENTS' QUALITY OF LIFE. THEY HAVE ALSO BECOME A CORNERSTONE IN THE MANAGEMENT OF CARDIOMYOPATHIES. CONVENTIONALLY, THESE DEVICES PACE THE VENTRICLE IN ISOLATION, WHICH CAN RESULT IN POOR COORDINATION BETWEEN ATRIAL AND VENTRICULAR CONTRACTION AND A SUBSEQUENT REDUCTION IN CARDIAC OUTPUT. THIS IS KNOWN AS PACEMAKER SYNDROME, AND MAY BE DUE TO ATRIAL CONTRACTION OCCURRING AGAINST CLOSED ATRIOVENTRICULAR (AV) VALVE OR ATRIAL CONTRACTION OCCURRING TOO CLOSE TO VENTRICULAR CONTRACTION, PRODUCING BACK-PRESSURE IN VENOUS CIRCULATION SYSTEMS AND LOSS OF ATRIAL CONTRIBUTION TO VENTRICULAR OUTPUT. THIS ACTIVITY REVIEWS THE PATHOPHYSIOLOGY OF PACEMAKER SYNDROME AND THE IMPORTANCE OF THE INTERPROFESSIONAL TEAM IN ITS MANAGEMENT.