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Related Experiment Videos

Adapter failure as a cause of pacemaker malfunction

B M van Gelder1, F A Bracke, M I el Gamal

  • 1Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.

Pacing and Clinical Electrophysiology : PACE
|October 1, 1993
PubMed
Summary

A protruding adapter set-screw caused short-circuiting during pulse generator replacement, leading to pacemaker noncapture. This resulted in dangerously low telementered impedance readings (< 100 ohms).

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Area of Science:

  • Cardiovascular medicine
  • Biomedical engineering
  • Implantable electronic devices

Background:

  • Pulse generator replacement is a common procedure for cardiac rhythm management.
  • Adapters are sometimes used to connect older leads to new pulse generators with different connector types (e.g., VS1 and IS1 3.2-mm connectors).
  • Ensuring proper lead-adapter-generator connection is critical for device function.

Observation:

  • Two patients experienced pacemaker noncapture following pulse generator replacement.
  • In both cases, an adapter was used to connect a preexisting lead to a new pulse generator.
  • The adapter's set-screw was observed to protrude through the insulation sleeve.

Findings:

  • The protruding set-screw caused a short circuit with the pulse generator's metal casing.

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  • During noncapture events, the telementered lead impedance was measured below 100 ohms.
  • This indicates a significant electrical fault within the implanted system.

    • Implications:

    • Improperly secured adapters pose a risk of device malfunction and patient harm.
    • Regular impedance monitoring is crucial for detecting lead integrity issues.
    • Device manufacturers and clinicians should be aware of potential risks associated with adapter use in lead revisions.