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[Recurrent ventricular fibrillation after defibrillation in a patient with pacemaker]
1Abteilung Innere Medizin-Schwerpunkt Kardiologie, Klinikum der Philipps-Universität Marburg. wilke3@mailer,uni-marburg.de
Medizinische Klinik (Munich, Germany : 1983)
|October 12, 2000
Summary
Repeated defibrillations damaged a pacemaker, causing ventricular fibrillation due to a spike-on-T phenomenon. Anterior-posterior electrode placement is recommended to prevent pacemaker damage during defibrillation.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- A 62-year-old patient with a dual-chamber pacemaker for binodal disease developed ventricular fibrillation.
- The patient had dilated cardiomyopathy and required 12 defibrillations pre-operatively for a hernia repair.
Observation:
- Ventricular fibrillation was attributed to a spike-on-T phenomenon.
- Pacemaker sensing function was lost due to an entrance block.
Findings:
- Explantation of the pacemaker successfully terminated the ventricular fibrillation.
- Repeated defibrillations damaged the pacemaker, leading to subsequent fibrillation episodes.
Implications:
- Pacemaker damage can occur from standard defibrillation electrode placement.
- Anterior-posterior electrode positioning is suggested to prevent pacemaker damage during defibrillation and cardioversion in pacemaker patients.