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[Increased Ventricular Pacing Threshold Caused by Intake of Dronedaron]
Katharina Wedler1, Árpad Dávid1, Thomas Körber2
1Warnow-Klinik Bützow, Klinik für Innere Medizin.
Deutsche Medizinische Wochenschrift (1946)
|February 19, 2020
Summary
A patient with a pacemaker experienced ineffective ventricular stimulation due to sick sinus syndrome. Reprogramming the pacemaker and discontinuing Dronedarone resolved the issue, highlighting medication
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- A 75-year-old patient with ischemic heart disease and sick sinus syndrome presented with vertigo and dyspnea.
- The patient had a pacemaker implanted 5.5 years prior and was recently prescribed Dronedarone for non-permanent atrial fibrillation.
Observation:
- The patient presented with unstable hemodynamics, a heart rate of 29 bpm, and second-degree atrioventricular block with Wenckebach periodicity.
- Pacemaker interrogation revealed adequate atrial function but ineffective ventricular pacing.
Findings:
- Pacemaker reprogramming successfully achieved effective ventricular stimulation.
- Cessation of Dronedarone was identified as a key factor in resolving the pacemaker dysfunction.
Implications:
- This case underscores the importance of evaluating medication, particularly Dronedarone, in patients experiencing permanent pacemaker dysfunction.
- Increased pacing thresholds should be investigated, and medication interactions considered to optimize pacemaker performance and patient outcomes.
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