What is pacemaker syndrome?

Updated: Oct 11, 2019
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jeffrey N Rottman, MD  more...
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Pacemaker syndrome is a phenomenon in which a patient feels symptomatically worse after pacemaker placement and presents with progressively worsening symptoms of congestive heart failure (CHF). This is mainly due to the loss of atrioventricular synchrony whereby the pathway is reversed and now has a ventricular origin. The atrial contribution to the preload is lost and cardiac output, as well as blood pressure, falls.

Immediate treatment is mainly supportive, whereas long-term treatment involves altering the pacemaker to restore atrioventricular synchrony and possible ventricular synchrony. For example, this may require changing the pacemaker from single-chamber to dual-chamber pacing or to dual-ventricular pacing.

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