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Disturbances in Heart Rhythm01:28

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Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
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The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
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Arrhythmias are irregular heart rhythms occurring when the heart's electrical impulses become abnormal. These disturbances can lead to various symptoms, depending on their severity and the underlying cause. Some common factors contributing to arrhythmias include hypoxia, ischemia, electrolyte imbalances, excessive catecholamine exposure, drug toxicity, and muscle overstretching. Arrhythmias can be classified into two main types based on the rate and site of origin of abnormal heart rhythms.
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Complete pacemaker failure following lightning strike injury: A case report.

Gustavo Gomes Torres1, William Santos de Oliveira1, Nestor Rodrigues de Oliveira Neto1

  • 1Department of Cardiology, Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, Brazil.

Pacing and Clinical Electrophysiology : PACE
|August 20, 2024
PubMed
Summary

Lightning strikes can severely damage cardiovascular implantable electronic devices (CIEDs), such as pacemakers. A patient with a pacemaker experienced significant device failure after a lightning injury, highlighting potential risks.

Keywords:
cardiovascular implantable electronic devicecomplete heart blockelectric shocklightningpacemaker

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrical Engineering

Background:

  • Modern cardiovascular implantable electronic devices (CIEDs) possess protective mechanisms against external electric shocks.
  • Malfunctions in CIEDs following accidental electrocution are infrequent.
  • The specific impact of lightning injuries on patients with CIEDs remains largely uncertain.

Observation:

  • A 74-year-old male with a dual-chamber pacemaker, implanted for complete heart block, was struck by lightning while engaged in farming.
  • Initially, the patient reported no significant injuries but presented a month later with asymptomatic bradycardia.
  • Device interrogation revealed substantial damage to the pacemaker's battery and leads.

Findings:

  • Unlike previous reports of minor pacing threshold elevation, this case demonstrated extensive damage to the entire pacing system.
  • The patient required extraction of the compromised system and implantation of a new pacing system.
  • Factors influencing the severity of device damage, including injury mechanism, pacemaker model, and current dispersion, are yet to be fully elucidated.

Implications:

  • Lightning strikes pose a significant, albeit rare, risk of severe damage to cardiovascular implantable electronic devices.
  • Healthcare providers should consider the potential for CIED malfunction in patients with a history of lightning exposure.
  • Further research is needed to understand the variables affecting CIED response to lightning strikes and to refine protective strategies.