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Pacemaker-mediated angina

Morhaf Ibrahim1, Reham Hasan

  • 1Department of Cardiology, University of South Alabama, Mobile, Alabama, USA.

Experimental and Clinical Cardiology
|December 3, 2013
PubMed

Insights

Pacemaker-mediated angina, a rare complication, occurred in a patient with chest pain after dual-chamber pacemaker placement. Switching the pacemaker mode relieved the angina, highlighting the importance of thorough patient history.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Case Reports

Background:

  • Angina pectoris is chest discomfort caused by myocardial ischemia, often due to atherosclerotic coronary artery disease.
  • Dual-chamber pacemakers are devices that coordinate atrial and ventricular electrical activity to maintain optimal heart rhythm.
  • Pacemaker-mediated tachycardia (PMT) can occur, but pacemaker-mediated angina is an infrequently reported complication.

Observation:

  • A 78-year-old male presented with chest pain shortly after the implantation of a permanent dual-chamber pacemaker.
  • The patient experienced immediate relief from his chest pain upon reprogramming the pacemaker.
  • The pacemaker was switched from tracking the atrium and pacing the ventricle to sensing and pacing the ventricle.

Findings:

  • The patient's chest pain was diagnosed as angina pectoris, directly linked to the pacemaker's function.
  • This represents the first reported case of angina mediated by a dual-chamber pacemaker in medical literature.
  • The specific pacemaker mode triggered the ischemic pain, suggesting a novel mechanism of pacemaker-induced angina.

Implications:

  • This case underscores the importance of considering pacemaker-mediated angina in patients experiencing chest pain post-implantation.
  • Thorough pre-pacemaker placement evaluation, including patient history, is crucial for identifying potential risks.
  • Reprogramming pacemaker settings can effectively manage and resolve pacemaker-mediated angina, offering a treatment strategy.

Keywords:
AnginaPacemakerPacemaker-mediated

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