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Related Experiment Videos

Unusual presentation of DDD pacemaker system malfunction.

S Stark, A Farshidi, W D Hager

    Pacing and Clinical Electrophysiology : PACE
    |March 1, 1985
    PubMed
    Summary

    A DDD pacemaker with an atrial J electrode dislodged in a patient lacking a right atrial appendage. Screw-in electrodes offer better stability than J electrodes in such cases, preventing pacemaker artifacts.

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    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Medical Device Technology

    Background:

    • Implantation of dual-chamber pacemakers (DDD) is common for cardiac rhythm management.
    • Right atrial appendage (RAA) removal during cardiac surgery can pose challenges for atrial lead placement.
    • Atrial lead dislodgement can lead to pacemaker malfunction and suboptimal therapy.

    Observation:

    • A patient with a history of RAA removal experienced alternating QRS morphologies due to pacemaker stimulus artifacts.
    • These artifacts were directly linked to the dislodgement of an implanted atrial J electrode.
    • The DDD pacemaker system utilized an atrial J electrode for sensing and pacing.

    Findings:

    • The atrial J electrode demonstrated inadequate stability in a patient with prior RAA removal.

    Related Experiment Videos

  • Screw-in atrial electrodes provide superior stability compared to J electrodes in patients who have undergone RAA removal.
  • Lead dislodgement was confirmed as the cause of the observed QRS morphology variations.

    • Implications:

    • Screw-in atrial electrodes are recommended for patients with a history of RAA removal to ensure lead stability.
    • Careful consideration of lead type is crucial in patients with altered atrial anatomy post-cardiac surgery.
    • Preventing lead dislodgement is essential for reliable pacemaker function and patient outcomes.