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Oversensing from electrode 'chatter' in a bipolar pacing lead: a case report
1Division of Cardiology, Francis Scott Key Medical Center, Baltimore, MD 21224.
Pacing and Clinical Electrophysiology : PACE
|June 1, 1990
Summary
Pacemaker oversensing due to electrode chatter can be self-limited. This issue, caused by ventricular lead artifact, resolved over weeks, allowing normal pacemaker function.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- High-degree atrioventricular (AV) block and syncope necessitate pacemaker implantation.
- Dual-chamber (DDD) pacemakers with bipolar active fixation leads are commonly used.
Observation:
- Intermittent oversensing from the ventricular lead was detected post-implantation, causing inappropriate inhibition of ventricular pacing.
- Spurious signals (5-15 mV) on the ventricular electrogram correlated with pacing inhibition.
Findings:
- Reprogramming to VVT mode initially addressed the oversensing.
- Normal DDD pacemaker function was restored within six weeks, with no further inhibition observed.
- Electrode 'chatter' between the ventricular lead's cathodal ring and helix was postulated as the cause of artifactual potentials.
Implications:
- Electrode 'chatter' is a potential cause of pacemaker oversensing that may be transient.
- Fibrosis and lead fixation can resolve oversensing by eliminating electromechanical artifacts.
- Clinicians should consider electrode 'chatter' in cases of pacemaker oversensing.