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Dizziness spells: Should one suspect the pacemaker?
Moustafa Elsheshtawy1, Felix Yang2, Sudhakar Prabhu1
1Department of Medicine, Division of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA 11219; Department of Medicine, Division of Cardiology, Coney Island Hospital, Brooklyn, NY, USA 11235.
Abstract:
A 52-year-old lady presented to the emergency department with recurrent episodes of dizziness and near-syncope on awakening up or swinging her left arm. Initial rhythm strips demonstrated intermittently non-conducted p waves corresponding to inappropriate pacemaker inhibition and oversensing malfunction. Pacemaker was interrogated in the ED showing ventricular lead noise and decreased lead impedance over a one year period. The patient was diagnosed with pacemaker lead failure supported by correlating pacemaker lead variation with homolateral arm movement. The patient was referred to an electrophysiologist and underwent new right ventricular lead placement with the resolution of symptoms.
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