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A case report of lead dysfunction presenting as high ventricular premature complex burden
Saurabh Ajit Deshpande1, Ameya Udyavar2
1CTVS, Jag Jivan Ram Western Railway Hospital, Mumbai, India.
Indian Pacing and Electrophysiology Journal
|October 19, 2021
Summary
Pacemaker troubleshooting is crucial for syncope after implantation. Lead dysfunction, even with normal basic tests, can be detected by analyzing premature ventricular beats.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Syncope after pacemaker implantation requires thorough troubleshooting.
- Lead dysfunction, including microfractures or insulation breaks, can present subtly.
- Standard pacemaker function tests may not always detect lead issues.
Purpose of the Study:
- To highlight a case of pacemaker lead dysfunction.
- To demonstrate the diagnostic utility of premature ventricular beats in identifying lead issues.
- To emphasize the importance of comprehensive pacemaker evaluation.
Main Methods:
- Case report analysis.
- Pacemaker function evaluation.
- Electrocardiogram (ECG) monitoring for arrhythmias.
Main Results:
- A patient experienced syncope post-pacemaker implantation.
- Standard pacemaker diagnostics appeared normal.
- Multiple premature ventricular beats were observed, indicating lead dysfunction.
Conclusions:
- Premature ventricular beats can be a key indicator of pacemaker lead dysfunction.
- Thorough troubleshooting, including arrhythmia analysis, is essential for diagnosing subtle lead problems.
- This case underscores the need to consider lead integrity beyond basic pacemaker function tests.
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