Pacemaker-Mediated Tachycardia Workup

Updated: Apr 15, 2022
  • Author: Brian Olshansky, MD, FESC, FAHA, FACC, FHRS; Chief Editor: Jose M Dizon, MD  more...
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Other Tests

Ventricular pacing at or near the upper rate limit of the pacemaker is evident on electrocardiography (ECG). The presence of a paced rhythm exactly at the upper rate limit with atrial sensing and exact A-V association warrants evaluation for pacemaker-mediated tachycardia (PMT).

A Holter monitor or event recorder also shows ventricular pacing at or near the upper rate limit and the initiation of the episodes. In the differential diagnosis of PMT, sinus and tracked atrial tachyarrhythmias must be considered. Monitoring of episodes, their initiation, and termination will help arrive at a diagnosis.

Telemetered intracardiac electrograms obtained through the pacemaker programmer generally indicate the diagnosis.