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Ventricular output failure in a DDD permanent pacemaker associated with increased atrial output
1Department of Electrophysiology, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60611-3833, USA.
Pacing and Clinical Electrophysiology : PACE
|March 1, 1997
Summary
Ventricular output failure can occur in DDD pacemaker systems with low atrial lead impedance, specifically after atrial pacing. This issue may lead to dangerous heart rhythm problems in pacemaker-dependent patients.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Permanent pacemaker systems, particularly DDD type, are crucial for managing bradyarrhythmias.
- Previous reports identified ventricular output failure linked to specific pacemaker models (Medtronic Synergyst/Synergyst II) under certain conditions.
- Low atrial lead impedance is a known factor that can influence pacemaker function.
Observation:
- A specific phenomenon of ventricular output failure was observed.
- This failure exclusively occurred following atrial paced events.
- The issue was noted in patients with a permanent DDD pacemaker system.
Findings:
- The observed phenomenon mimicked previously reported issues with Medtronic Synergyst/Synergyst II pacemakers.
- This analogous behavior was documented in a Medtronic Symbios 7006 generator.
- The failure mechanism appears related to an increase in atrial output when atrial lead impedance is low.
Implications:
- This finding highlights a potential risk of bradyarrhythmia or ventricular asystole in pacemaker-dependent individuals.
- It suggests that the Medtronic Symbios 7006 generator may exhibit similar vulnerabilities to the Synergyst/Synergyst II models.
- Further investigation into pacemaker-device interactions and lead integrity is warranted to ensure patient safety.