Tachycardia Mediated by an AV Universal (DDD) Pacemaker Triggered by a Ventricular Depolarization

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Abstract
A 44‐year‐old female had Chagas’ disease with right bundle branch block, right axis deviation, and ventricular ectopic beats. An invasive evaluation showed a prolonged HV interval of 100 ms. A Medtronic Versatrax 7000 was implanted, after which a pacemaker‐mediated tachycardia was observed. The esophageal lead ruled out the possibility of an atrial triggered tachycardia. The diagnosis was pacemaker‐mediated tachycardia due to abnormal sensing of the terminal forces of the ventricular activation because of malposition of the atrial lead in the right ventricular out‐flow tract.

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