Pacemaker syndrome medical therapy

Jump to navigation Jump to search

Pacemaker syndrome Microchapters



Historical Perspective


Differentiating Pacemaker syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis


History and Symptoms

Physical Examination

Laboratory Findings


Chest X Ray


Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Pacemaker syndrome medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs



American Roentgen Ray Society Images of Pacemaker syndrome medical therapy

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pacemaker syndrome medical therapy

CDC on Pacemaker syndrome medical therapy

Pacemaker syndrome medical therapy in the news

Blogs on Pacemaker syndrome medical therapy

Directions to Hospitals Treating Pacemaker syndrome

Risk calculators and risk factors for Pacemaker syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Medical Therapy


Diet alone cannot treat pacemaker syndrome, but an appropriate diet to the patient, in addition to the other treatment regimens mentioned, can improve the patient's symptoms.

Dietary management includes:


No specific drugs are used to treat pacemaker syndrome directly because treatment consists of upgrading or reprogramming the pacemaker.

Medical Care

  • Prevent ventriculoatrial conduction by slowing the rate of ventricles setting in pacemaker and restoring Atrioventricular synchrony.
  • In ventricularly paced patients, usually the addition of an atrial lead and optimizing the AV synchrony usually resolves symptoms.
  • In patients with pacing modes other than ventricular pacing, symptoms usually resolve after adjusting and reprogramming of pacemaker parameters, such as tuning the AV delay, changing the postventricular atrial refractory period, the sensing level, and pacing threshold voltage. The optimal values of these parameters for each individual differ. So, achieving the optimal values is by experimenting with successive reprogramming and measurement of relevant parameters, such as blood pressure, cardiac output, and total peripheral resistance, as well as observations of symptomatology.
  • Using hysteresis to help maintain AV synchrony, in some instances, can help alleviate symptoms in ventricularly inhibited paced (VVI) patients providing they have intact sinus node function. Hysteresis reduces the amount of time spent in pacing mode, which can relieve symptoms, particularly when the pacing mode is generating AV dyssynchrony.
  • If symptoms persist after all these treatment modalities, replacing the pacemaker itself is sometimes beneficial and can alleviate symptoms.


Template:WH Template:WS [1]

  1. Ausubel K, Boal BH, Furman S (1985). "Pacemaker syndrome: definition and evaluation". Cardiol Clin. 3 (4): 587–94. PMID 3910239.