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Induction of ventricular tachycardia by pacemaker programming.

W Scheibelhofer, D Glogar, P Probst

    Pacing and Clinical Electrophysiology : PACE
    |July 1, 1982
    PubMed
    Summary
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    Competitive pacing can induce ventricular arrhythmias, particularly during acute myocardial ischemia. A case highlights how reprogramming a unipolar pacemaker can trigger ventricular tachycardia, suggesting magnet use during reprogramming should be reconsidered.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Medical Device Technology

    Background:

    • Competitive pacing is a known trigger for ventricular tachycardia (VT) and ventricular fibrillation (VF), especially in patients with acute myocardial ischemia.
    • Unipolar pacemakers, while common, have specific characteristics that may influence their interaction with pacing algorithms and patient physiology.

    Observation:

    • A specific case involved a multiprogrammable unipolar cathodal ventricular pacemaker (Spectrax 5985 SX).
    • Ventricular tachycardia was induced during the process of pacemaker reprogramming.
    • The reprogramming sequence required a temporary switch to fixed rate pacing, which precipitated the arrhythmia.

    Findings:

    • Reprogramming of this unipolar pacemaker model can induce ventricular tachycardia.

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  • The mechanism involves competitive pacing during a specific reprogramming maneuver (switch to fixed rate pacing).
  • This specific hazard associated with unipolar pacemaker reprogramming is not widely recognized.

    • Implications:

    • Clinicians should be aware of the potential for induced ventricular arrhythmias during reprogramming of unipolar pacemakers.
    • The use of magnets as a prerequisite for reprogramming may pose a risk in certain unipolar pacemaker models.
    • Future pacemaker designs and reprogramming protocols should consider mitigating this potential hazard to enhance patient safety.