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Resetting of DDD pulse generators due to cold exposure
S S Barold1, M D Falkoff, L S Ong
1Department of Medicine, Genesee Hospital, Rochester, New York.
Pacing and Clinical Electrophysiology : PACE
|June 1, 1988
Summary
Cold exposure can cause dual-chamber (DDD) pacemakers to reset to single-chamber (VVI) mode. Interrogate pacemakers before implantation, as cold exposure is a likely cause of VVI resetting.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Dual-chamber (DDD) pulse generators are crucial for cardiac rhythm management.
- Device malfunction during or before implantation can have serious clinical consequences.
- Environmental factors like temperature extremes may affect pacemaker function.
Purpose of the Study:
- To investigate the impact of cold exposure on DDD pulse generator function.
- To determine the susceptibility of DDD pacemakers from various manufacturers to cold-induced resetting.
- To assess the response of reset pacemakers to magnetic interrogation.
Main Methods:
- Five lithium-powered DDD pulse generators from different manufacturers were subjected to cold exposure.
- Pacemaker behavior, including mode switching and response to magnetic application, was monitored.
- Comparison of pre- and post-exposure device interrogation data.
Main Results:
- Three out of five DDD pulse generators reset to the VVI pacing mode following cold exposure.
- Only one of the reset devices converted to the asynchronous (VOO) mode upon magnet application; the others remained in VVI mode.
- Cold exposure is identified as a significant risk factor for DDD pacemaker resetting.
Conclusions:
- Routine interrogation of DDD pulse generators before implantation is essential to detect cold-induced resetting.
- Reset DDD pulse generators due to cold exposure can typically be reprogrammed to the DDD mode.
- Absence of magnet response in a reset VVI pacemaker should not be misconstrued as component failure.