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Acute myocardial ischemia during pacemaker implantation: implication for threshold determinations and potential
Pacing and Clinical Electrophysiology : PACE
|January 1, 1983
Summary
Acute myocardial ischemia during pacemaker implantation can falsely elevate threshold values, potentially leading to incorrect device programming. Monitoring angina relief is crucial for safe pacemaker implantation and accurate threshold measurements.
Area of Science:
- Cardiology
- Biomedical Engineering
- Electrophysiology
Background:
- Pacemaker implantation requires accurate threshold measurements for safe and effective device function.
- Acute myocardial ischemia is a potential complication during cardiac procedures.
Observation:
- Ischemia can significantly alter myocardial electrical properties, affecting pacing thresholds.
- Muscle in an ischemic area is more susceptible to arrhythmias when stimulated.
Findings:
- Two cases demonstrated sharp increases in pacing threshold values during ischemic episodes.
- Threshold values returned to baseline after ischemic symptoms (angina) resolved.
Implications:
- Ischemia-induced threshold changes can lead to inappropriate programming of high generator output.
- Relief of angina serves as a vital clinical indicator for proceeding with implantation and threshold assessment.
- Recognizing ischemia's impact on thresholds enhances patient safety during pacemaker procedures.