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Runaway pacemaker.

Ambreen Gul1, Muhammad Asad Sheikh1, Atif Rao1

  • 1Department of Cardiology, Southend University Hospital NHS Foundation Trust, Westcliff-on-Sea, UK.

BMJ Case Reports
|April 3, 2019
PubMed
Summary
This summary is machine-generated.

A rare runaway pacemaker event caused ventricular tachycardia in a patient with a VVI pacemaker. Prompt magnet application and device replacement successfully resolved the tachycardia and restored normal heart rhythm.

Keywords:
arrhythmiaspacing and electrophysiology

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • A runaway pacemaker is a rare malfunction where the pacemaker inappropriately stimulates the ventricle, leading to ventricular tachycardia.
  • This case involves a 75-year-old male with a history of a Single Chamber Ventricular (VVI) pacemaker implanted in 1996.

Observation:

  • The patient presented with symptoms of chest fluttering, shortness of breath, and chest pain.
  • Electrocardiogram (ECG) revealed ventricular tachycardia with rapid ventricular pacing (200-150/min).

Findings:

  • Applying a magnet to the pacemaker immediately terminated the ventricular tachycardia and restored a normal sinus rhythm at 60/min.
  • Urgent explantation and replacement of the pacemaker pulse generator were performed.

Implications:

  • This case highlights the importance of recognizing and rapidly managing pacemaker-induced tachycardia.
  • Successful intervention involved immediate magnet application followed by device replacement, ensuring patient stability.