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Related Experiment Videos

Inappropriate slowing of the pacemaker rate with programmable demand pacemaker

L Gould, C V Reddy, B K Singh

    Pacing and Clinical Electrophysiology : PACE
    |May 1, 1979
    PubMed
    Summary

    Programmable pacemaker issues can arise from T-wave oversensing, not generator malfunction. Reprogramming pulse duration or milliamperage often resolves inappropriate rate slowing.

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    Area of Science:

    • Cardiology
    • Biomedical Engineering
    • Electrophysiology

    Background:

    • Programmable pacemakers are crucial for managing bradyarrhythmias.
    • Pacemaker function relies on accurate sensing of intrinsic cardiac electrical activity.
    • Oversensing can lead to inappropriate pacemaker inhibition or altered pacing rates.

    Observation:

    • A 60-year-old male patient experienced an unintended decrease in pacemaker rate.
    • This event was linked to the pacemaker erroneously detecting T waves and after-potentials.
    • The pacemaker's programmability allowed for detailed analysis of sensing parameters.

    Findings:

    • The inappropriate slowing was attributed to oversensing of T waves and after-potentials.
    • This phenomenon is a sensing issue, not indicative of a device generator malfunction.

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  • Specific programmable parameters, pulse duration and milliamperage, were identified as modifiable factors.

    • Implications:

    • Understanding T-wave and after-potential oversensing is key for pacemaker troubleshooting.
    • Reprogramming pulse duration or milliamperage offers a non-invasive solution.
    • This highlights the importance of precise pacemaker programming for optimal patient outcomes.