Algimantas Medzevičius, Vida Medzevičienė

Key words: atrioventricular conduction, pacemaker syndrome, cardiac pacing.

Summary. The pacemaker syndrome is a complex of clinical signs and symptoms related to the adverse hemodynamic and electrophysiologic consequences of ventricular pacing in the absence of other causes and temporarily related to the onset of ventricular pacing. The aim of the study was to evaluate significance of clinical symptoms and Doppler echocardiography in diagnostics of pacemaker syndrome. 53 patients with a permanent ventricular VVI, VVIR pacemakers were symptomatic: hypotension, dizziness, fatigue, palpitation, angina, dyspnea, weakness and congestive heart failure. Atrial fibrillation occurred in 41 patients (77.3%). The Doppler hemodynamic study revealed reduction in mean stroke volume from 62.3±9.7 ml in sinus rhythm to 52.2±3.1 ml with onset of ventricular pacing

Treatment of the pacemaker syndrome entails restoration of atrioventricular synchrony and prevention of ventriculoatrial conduction by decreasing of pacemaker activation, by sequential pacing, or by antiarrhythmic therapy.