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Runaway pacemaker in an implantable cardioverter defibrillator
C M Carpenter1, J Galvin, M Guy
1Department of Medicine, Massachusetts General Hospital, Boston 02114, USA.
Journal of Cardiovascular Electrophysiology
|October 24, 1998
Summary
A rare crystal oscillator failure in an implantable cardioverter defibrillator (ICD) caused a fatal runaway pacing event. This highlights a previously unrecognized component malfunction risk in cardiac electronic devices.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Runaway pacemaker events, characterized by rapid, uncontrolled pacing, represent a severe complication of permanent pacing systems.
- Implantable cardioverter defibrillators (ICDs) are crucial for managing life-threatening arrhythmias but are susceptible to device malfunctions.
Observation:
- A 70-year-old male patient exhibited erratic behavior of his ICD during a routine check-up.
- The device was deactivated, and the patient was hospitalized for pulse generator replacement.
Findings:
- During hospitalization, the patient's ICD unexpectedly initiated rapid pacing.
- Despite immediate resuscitation efforts, the patient unfortunately passed away.
- Postmortem analysis revealed a crystal oscillator failure within the ICD as the cause of the malfunction.
Implications:
- This case identifies a previously unrecognized component failure mode in ICDs.
- Such malfunctions can lead to potentially lethal outcomes, emphasizing the need for enhanced device surveillance and failure analysis.
- Understanding rare component failures is critical for improving the safety and reliability of cardiac electronic devices.