An unusual cause of a common response. What is the mechanism of initiation of pacemaker mediated tachycardia?

Anand Manickavasagam; Sirish Chandra Srinath Patloori; Kulkarni Yogesh Jagannath; John Roshan

doi:10.1016/j.jelectrocard.2026.154259

An unusual cause of a common response. What is the mechanism of initiation of pacemaker mediated tachycardia?

J Electrocardiol. 2026 May-Jun:96:154259. doi: 10.1016/j.jelectrocard.2026.154259. Epub 2026 Apr 13.

Authors

Anand Manickavasagam¹, Sirish Chandra Srinath Patloori¹, Kulkarni Yogesh Jagannath¹, John Roshan²

Affiliations

¹ Department of Cardiology, Christian Medical College, Vellore, Tamilnadu, India.
² Department of Cardiology, Christian Medical College, Vellore, Tamilnadu, India. Electronic address: johnroshanjacob@gmail.com.

PMID: 42013654
DOI: 10.1016/j.jelectrocard.2026.154259

Abstract

40-year-old gentleman who underwent permanent pacemaker implantation for intermittent complete heart block had episodes of pacemaker mediated tachycardia on device logs. The cause for endless loop tachycardia was unique in this case. The mechanism behind the initiation of the tachycardia and how to prevent it are discussed in this article.

Keywords: Autosensitivity; Endless loop tachycardia; Retrograde AV conduction; Undersensing.

Publication types

Case Reports

MeSH terms

Adult
Diagnosis, Differential
Electrocardiography
Heart Block* / therapy
Humans
Male
Pacemaker, Artificial* / adverse effects
Tachycardia* / diagnosis
Tachycardia* / etiology
Tachycardia* / prevention & control