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Pacemaker syndrome and pseudo-ventricular high threshold after dual-chamber pacemaker replacement.
Antoine Kossaify1, Nicolas Moussallem
1USEK-NDS University Hospital, Department of Cardiology, St Charbel Street, Byblos, Jbeil, Lebanon. antoinekossaify@yahoo.com
Summary
Pacemaker syndrome occurred due to inverted dual-chamber pacemaker leads after replacement. This lead inversion caused serious complications in a pacer-dependent patient, highlighting the need for expert physician supervision during device assistance.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Pacemaker implantation is a common procedure for managing cardiac rhythm disorders.
- Dual-chamber pacemakers offer advanced pacing capabilities but require precise lead placement.
- Pacemaker syndrome can manifest due to suboptimal device function or lead issues.
Observation:
- A 60-year-old male patient developed pacemaker syndrome following a dual-chamber pacemaker replacement.
- Surface ECG and endocavitary electrograms indicated an inversion of the pacemaker leads.
- Device interrogation revealed a pseudo-ventricular high threshold, suggesting lead malfunction.
Findings:
- Inversion of dual-chamber pacemaker leads can lead to significant device malfunction.
- This specific lead misplacement resulted in a pseudo-ventricular high threshold.
- The patient experienced symptoms consistent with pacemaker syndrome due to the lead inversion.
Implications:
- Dual-chamber pacemaker lead inversion poses a risk of life-threatening complications in pacer-dependent patients.
- Unsupervised technical assistance by industry personnel during device replacement or maintenance is hazardous.
- Ensuring physician expertise and supervision during pacemaker device procedures is critical for patient safety.
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