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Scintigraphic Demonstration of Ventriculo Atrial Conduction in the Ventricular Pacemaker Syndrome

University of Michigan Medical Center, Ann Arbor, Michigan

Correspondence: For reprints contact: Mark A. Rabinovitch, MD. Div. of Nuclear Medicine, Box 21, Univ. of Michigan Medical Center, 1405 E. Ann Street, Ann Arbor, MI 48109.

ABSTRACT

A patient with the sick-sinus syndrome was evaluated because of symptomatic deterioration after insertion of a ventricular demand pacemaker. Clinical features of the ventricular pacemaker syndrome were recognized and confirmed by electrophysiological and hemodynamic studies. Phase analysis—a new technique for detecting patterns of cardiac emptying from gated cardiac blood-pool scintigrams—demonstrated a pattern consistent with 1:1 ventriculo-atrial conduction. Phase analsysis of the gated cardiac blood-pool scintigram may be useful in the assessment of patients with ventricular demand pacemakers who complain of fatigue and effort intolerance.