Tachycardia-induced cardiomyopathy caused by a special pacemaker algorithm

An elderly lady presented with breathlessness, fever and palpitations. She was treated for community-acquired pneumonia with antibiotics. Subsequently, she went into acute pulmonary edema. She was managed with standard heart failure medications and a trial of non-invasive ventilation. ECG showed A-V sequential pacing at a rate of 150/min with broad QRS. It was thought to be a pacemaker-related tachycardia. On pacemaker check, a special algorithm (atrial fibrillation suppression algorithm) was switched off. She subsequently improved. We here review the cause of this tachycardia-induced cardiomyoapthy. (Cardiol J 2011; 18,5: 573-576)