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Related Experiment Videos

P wave oversensing in a unipolar VVI pacemaker

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

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

Pacing and Clinical Electrophysiology : PACE
|February 1, 1995
PubMed
Summary

A pacemaker lead defect caused a VVI pacemaker to malfunction, leading to syncope. This occurred due to friction between the implanted and abandoned leads, inhibiting the pacemaker with P waves.

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Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Electrophysiology

Background:

  • A 45-year-old male with a history of complete heart block received a VVI pacemaker 20 years prior.
  • Initial lead perforation necessitated removal and contralateral lead implantation.

Observation:

  • The patient presented with recurrent lightheadedness and syncope.
  • Electrocardiogram (ECG) revealed prolonged pauses.
  • Intracardiac electrogram telemetry indicated pacemaker inhibition by P waves.

Findings:

  • The VVI pacemaker was inappropriately inhibited by native P waves.
  • The most probable cause identified was an insulation defect in the functioning lead.
  • This defect was attributed to friction with the previously abandoned lead in the high right atrium.

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Implications:

  • This case highlights a rare complication of pacemaker lead interaction.
  • Understanding lead insulation failure is crucial for long-term pacemaker management.
  • Potential for lead abrasion necessitates careful lead placement and follow-up.