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The case of the two-timing pacemaker.

T P Comer, N Saxena, S H Salzman

    Pacing and Clinical Electrophysiology : PACE
    |July 1, 1981
    PubMed
    Summary
    This summary is machine-generated.

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    A pacemaker malfunction caused a patient

    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Medical Device Technology

    Background:

    • Permanent transvenous pacemakers are crucial for managing bradycardia.
    • Device malfunction can lead to serious hemodynamic instability.
    • Understanding pacemaker failure modes is vital for patient safety.

    Observation:

    • A 71-year-old male presented with severe shortness of breath and hypotension (80/50 mmHg).
    • The patient had a history of lightheadedness and a permanent transvenous pacemaker.
    • Tachycardia (148 bpm) was noted, which coincidentally normalized to 70 bpm upon blood pressure restoration with a pressor drug.

    Findings:

    • The patient's symptoms were attributed to a dendritic spur in the pacemaker's programming circuit.
    • This spur caused intermittent doubling of the pacemaker's impulse frequency.

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  • The pacemaker malfunction led to significant hemodynamic compromise.

    • Implications:

    • This case highlights a rare but critical pacemaker malfunction.
    • Prompt diagnosis and surgical intervention (pacemaker replacement) led to full recovery.
    • Emphasizes the need for vigilance in monitoring pacemaker function and considering device-related issues in patients with hemodynamic instability.