Related Experiment Videos
Symptomatic unilateral cannon "a" waves in a patient with a ventricular pacemaker
Chest
|April 1, 1978
Summary
A 64-year-old woman experienced neck and facial pulsations after pacemaker insertion due to heart block. Symptoms resolved by switching to atrial synchronous pacing, highlighting its benefits.
Area of Science:
- Cardiology
- Biomedical Engineering
- Vascular Medicine
Background:
- A 64-year-old woman presented with intermittent pulsations on the left side of her neck, face, and scalp.
- These symptoms began after the insertion of a ventricular pacemaker to manage symptomatic 2:1 atrioventricular block.
Observation:
- Cardiac catheterization revealed characteristic cannon "a" waves.
- Phlebographic studies identified stenosis in the right innominate and internal jugular veins.
Findings:
- The patient's symptoms were directly linked to the ventricular pacing system.
- Conversion to an atrial synchronous pacing system successfully abolished the pulsations.
Implications:
- This case underscores the potential for "pacemaking syndrome" due to ventricular pacing.
- Atrial synchronous pacing offers a viable solution for managing such hemodynamic complications.
- Understanding venous stenosis is crucial in pacemaker-related symptomology.