Pacemaker-Induced Ventricular Tachycardia

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Abstract
PARASYMPATHETIC action in influencing electrophysiologic events in the ventricles has been debated. We report a case of ventricular tachycardia produced by a transvenous catheter pacemaker. The tachycardia was twice converted by left carotid massage, implying parasympathetic action in the ventricle. Report of a Case A 56-year-old woman was admitted to the hospital for pelvic laparotomy for an adnexal mass. She was also to have upperabdominal exploration at surgery and possible gastric surgery because of an abnormality on roentgenograms. She had a history of mild hypertension and was being treated with methyldopa (250 mg twice daily) and a spironolactonehydrochlorothiazide combination (Aldactazide) twice daily. During preoperative assessment, she had normal complete blood cell count (CBC), creatinine clearance, and serum electrolyte levels. However, her ECG showed intermittent sinus bradycardia, periods of sinus arrest with junctional escaped beats, and, at times, apparent 2:1 sinoatrial exit block. No symptoms suggestive of bradycardia were reported, and

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