Paroxysmal bouts of Tachycardia associated with light-headedness
A 70-year-old man was brought to A&E with paroxysmal bouts of broad complex tachycardia associated with palpitations and light-headedness. Episodes were frequent lasting 5-6 seconds and appeared to self-resolve briefly before re-initiating. His medical history included treatment for hypertension and implantation of a dual chamber pacemaker implanted six months previously for sick sinus syndrome. A 12-lead recorded during an episode capturing the onset of tachycardia is displayed in figure 1. Pacemaker settings are displayed below.
Base rate: 60 bpm
Upper tracking rate: 130 bpm
Sensed AV delay: 150 ms
Paced AV delay: 180 ms
PVARP: 280 ms
A 12 lead ECG recorded during an episode of palpitations associated with light-headedness.