Fainting episode in a pacemaker dependent patient with two implanted devices. Too much of a good thing!

Filippo Maria Cauti; Pietro Rossi; Luigi Iaia; Stefano Bianchi

doi:10.1016/j.jelectrocard.2017.04.011

Fainting episode in a pacemaker dependent patient with two implanted devices. Too much of a good thing!

J Electrocardiol. 2017 Sep-Oct;50(5):674-677. doi: 10.1016/j.jelectrocard.2017.04.011. Epub 2017 Apr 22.

Authors

Filippo Maria Cauti¹, Pietro Rossi², Luigi Iaia², Stefano Bianchi²

Affiliations

¹ Arrhythmology Unit, Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy. Electronic address: filippocauti@hotmail.it.
² Arrhythmology Unit, Ospedale S. Giovanni Calibita, Fatebenefratelli Isola Tiberina, Rome, Italy.

PMID: 28476432
DOI: 10.1016/j.jelectrocard.2017.04.011

Abstract

A 73 year old man with CRT-D system and pacemaker dependence was admitted to the emergency department due to a syncopal episode. The device interrogation was performed. An RV ventricular sensing test was executed in VVI mode at 50 b/m. During testing the patient developed transient loss of consciousness with full recovery after stopping the sensing test. Applying asynchronous pacing mode, a pacing spike occurred at a faster rate of 65 b/m without evoking any ventricular capture. Looking at the chest X-ray, we found an abandoned right sided, single chamber VVI pacemaker in a submuscular pocket. The CRT-D system was positioned on the left side. The abandoned pacemaker was in ERI and it switched to VVI 65 b/m resulting in inhibition CRTD device during sensing test. This troubleshooting highlights the possible interference between two devices.

Keywords: ICD problems; ICD troubleshooting; Pacemaker malfunction; Syncope.

Publication types

Case Reports

MeSH terms

Aged
Cardiac Pacing, Artificial / methods*
Cardiac Resynchronization Therapy / methods*
Defibrillators, Implantable / adverse effects*
Equipment Failure Analysis
Humans
Male
Pacemaker, Artificial / adverse effects*
Syncope*