Novel cause of spurious mode switching in dual-chamber pacemakers: atrioventricular desynchronization arrhythmia.

Spurious mode switching is a common problem in DDDR pacing and implantable cardioverter defibrillator systems. It may produce symptoms indistinguishable from classic pacemaker syndrome or paroxysmal atrial arrhythmias due to loss of AV synchrony. The dominant cause of spurious mode switching is oversensing of far-field R waves. This report describes a novel cause of spurious mode switching, AV desynchronization arrhythmia. Clinical manifestations, recognition, and management are discussed.