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A patient with a dual-chamber permanent pacemaker for complete heart block presented with chest discomfort and a sensation of his heart fluttering. His electrocardiogram demonstrated a broad complex tachycardia (panel A). The presence of pacing spikes preceding each broad complex beat led to a diagnosis of pacemaker-mediated tachycardia (PMT). The arrhythmia responded …
Competing interests None.
Provenance and peer review Not commissioned; not externally peer reviewed.