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Sudden-onset severe presyncope in a 67-year-old man
Katie Hannah Sanders1, Claire A Martin2, Munmohan Virdee1
1Cardiology Department, Addenbrooke's Hospital, Cambridge, UK.
Heart (British Cardiac Society)
|December 6, 2018
Summary
A pacemaker malfunction caused a patient
Area of Science:
- Cardiology
- Medical Devices
Background:
- A 67-year-old man with persistent atrial fibrillation (AF) history presented with presyncope.
- He had a pacemaker implanted in 2006 and upgraded to cardiac resynchronization therapy (CRT) in 2016.
Observation:
- ECG revealed AF with a slow ventricular escape rhythm and pauses.
- Magnet application over the device initiated pacing.
Findings:
- Device interrogation and chest radiograph were performed.
- The cause of presentation was identified as noise oversensing on the right ventricular (RV) lead due to lead fracture.
Implications:
- This case highlights the importance of considering lead fracture in pacemaker malfunction.
- Proper lead management and device interrogation are crucial for patient safety.
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