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Pacemaker 'Dysfunction' Treated by Radiofrequency Ablation
- Source :
- Pacing and Clinical Electrophysiology. 36:772-774
- Publication Year :
- 2012
- Publisher :
- Wiley, 2012.
-
Abstract
- A 68-year-old female with a history of paroxysmal atrial fibrillation and complete atrioventricular (AV) block was referred for palpitations and suspicion of pacemaker dysfunction (model Philos II DR-T, Biotronik, Berlin, Germany). Baseline electrocardiogram (ECG) showed a dual-chamber pacemaker with an inappropriate behavior (Fig. 1, Panel A). Pacemaker programmed parameters were as follows: pacing mode DDD-R; basic rate 60 beats per minute (bpm); upper rate 130 bpm; dynamic paced AV delay 180/140 ms; dynamic sensed AV delay 135/95 ms; AV safety window 100 ms; atrial sensitivity 0.5 mV (bipolar); ventricular sensitivity 2.5 mV (bipolar); atrial and ventricular pulse amplitude and width 3.6 V and 0.40 ms, respectively (both unipolar). Pacemaker testing showed the following results: battery impedance 0.3 k ; sensed P wave 3 mV, sensed R wave 25 mV; atrial and ventricular pacing thresholds 0.6 and 0.4 V, respectively; atrial and ventricular lead impedances 442 and 560 , respectively (stable). Testing of the atrial pacing threshold in AAI mode at 70 bpm allowed the diagnosis to be made (Fig. 1, Panel B). What is the mechanism of the pacemaker “dysfunction”? How can it be solved?
- Subjects :
- medicine.medical_specialty
Atrial pacing
business.industry
Paroxysmal atrial fibrillation
Radiofrequency ablation
medicine.medical_treatment
P wave
Catheter ablation
General Medicine
Av delay
law.invention
QRS complex
law
Internal medicine
cardiovascular system
Cardiology
Palpitations
Medicine
cardiovascular diseases
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 01478389
- Volume :
- 36
- Database :
- OpenAIRE
- Journal :
- Pacing and Clinical Electrophysiology
- Accession number :
- edsair.doi...........8d833b95fe19006debee3ba50e641b6a
- Full Text :
- https://doi.org/10.1111/j.1540-8159.2012.03442.x