712 results match your criteria Pacemaker Malfunction

Risk of cardiac implantable electronic device malfunctioning during pencil beam proton scanning in an in vitro setting.

Int J Radiat Oncol Biol Phys 2021 Apr 9. Epub 2021 Apr 9.

Danish Centre for Particle Therapy, Aarhus University Hospital, Denmark.

Purpose: Cardiac implantable electronic devices (CIED) are sensitive to scattered secondary neutrons from proton beam irradiation. This experimental in vitro study investigated risk of CIED errors during pencil beam proton therapy.

Methods And Material: We used 62 explanted CIEDs from four manufacturers; 49 CIEDs were subjected to a simulated clinical protocol with daily 2 Gy relative biological effectiveness (RBE) fractions prescribed to the phantom. Read More

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Conformal Radiotherapy in Patients with Cardiovascular Implantable Electronic Devices: Proposed Practical Implementation of the TG-203 Risk-Stratified Interrogation Schedule.

Pract Radiat Oncol 2021 Apr 3. Epub 2021 Apr 3.

Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD. Electronic address:

Introduction: Radiotherapy (RT) in patients with cardiac implantable electronic devices (CIED) carries a risk of device malfunction from radiation exposure. We sought to evaluate the incidence of CIED malfunction in a cohort of patients treated with modern RT techniques.

Material And Methods: A retrospective analysis of 193 CIED patients treated with RT between 2000 and 2018 was conducted. Read More

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Unexplained syncope during pacemaker interrogation: Wand, AutoCapture or Lead- Which one is the elusive culprit?

Pacing Clin Electrophysiol 2021 Apr 5. Epub 2021 Apr 5.

Dept of Cardiology, Medica Superspeciality, Kolkata, India.

A 65 year-old-gentleman underwent dual chamber pacemaker implantation (DDDR, St Jude Medical) 7 years back for infra-hisian complete heart block. He was completely asymptomatic and came for his annual routine check-up. After undergoing ECG with and without magnet, he was prepared for device evaluation. Read More

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Feasibility of MRI in patients with non-Pacemaker/Defibrillator metallic devices and abandoned leads.

J Biomed Sci Eng 2021 Mar 9;14(3):83-93. Epub 2021 Mar 9.

Cardiovascular MRI Center, Allegheny Health Network Cardiovascular Institute, Pittsburgh, PA 15212.

Objective: To evaluate feasibility of MRI in patients with non-pacemaker (PM)/ Implantable cardioverter defibrillator (ICD) metallic devices and abandoned leads.

Background: Relative safety of MRI performed using specified protocol has been established in MR non-conditional PM/ICDs. With limited safety data, many non-PM/ICD metallic devices and abandoned leads continue to be a contraindication for MRI. Read More

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A case report of inappropriate inhibition of ventricular pacing due to a unique pacemaker electrogram storage feature.

Eur Heart J Case Rep 2021 Mar 20;5(3):ytab096. Epub 2021 Mar 20.

London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada.

Background: Modern permanent pacemakers (PPMs) have individual features designed to identify cardiac rhythm abnormalities and improve their performance. Inappropriate pacing inhibition may be an undesired outcome from these features and cause symptoms in patients who require frequent pacing, leading to dizziness, and syncope. Inappropriate inhibition can be difficult to identify in circumstances that are intermittent and difficult to reproduce. Read More

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Sudden cardiac death after implantation of a cardiac resynchronization therapy pacemaker: a case report illustrating that not always .

Eur Heart J Case Rep 2021 Feb 1;5(2):ytaa540. Epub 2021 Jan 1.

Herz- & Gefäßzentrum Göttingen am Agaplesion Krankenhaus Neu Bethlehem, Humboldtallee 6, 37073 Göttingen, Germany.

Background: Cardiac resynchronization therapy (CRT) improves symptoms and survival in selected patients with systolic heart failure and ventricular conduction delay. In subjects without prior life-threatening ventricular arrhythmia, clinicians have to select between implanting a CRT pacemaker (CRT-P) or a more complex device with additional defibrillator capability (CRT-D). This individual decision can be challenging in light of the available evidence and the potential risks and benefits. Read More

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February 2021

Syncope triggered by atrial flutter in a patient with a pacemaker: cross-stimulation-a case report.

Eur Heart J Case Rep 2021 Feb 18;5(2):ytab041. Epub 2021 Feb 18.

Cardiology Department, Hospital Universitario Lucus Augusti, Lugo, Spain.

Background: Syncope in a patient with a pacemaker is a serious event requiring urgent action to ascertain its cause. Around 5% of cases are due to a pacemaker system malfunction.

Case Summary: An 82-year-old man underwent dual-chamber permanent pacemaker implantation due to intermittent high-degree atrioventricular block (AVB) in sinus rhythm. Read More

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February 2021

Long-Term Technical Performance of the Osypka QT-5 Ventricular Pacemaker Lead.

J Clin Med 2021 Feb 8;10(4). Epub 2021 Feb 8.

Department of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, 6020 Innsbruck, Austria.

Background: Lead-associated complications and technical issues in patients with cardiac implantable electronic devices are common but underreported in the literature.

Methods: All patients undergoing implantation of the Osypka QT-5 ventricular lead at the University Clinic St. Pölten between 1 January 2006 and 31 December 2012 were retrospectively analyzed ( = 211). Read More

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February 2021

Causes of syncopal recurrences in patients treated with permanent pacing for bradyarrhythmic syncope: Findings from the SYNCOPACED registry.

Heart Rhythm 2021 May 16;18(5):770-777. Epub 2021 Jan 16.

Cardiology Unit, "Card. G. Panico" Hospital, Tricase, Italy.

Background: Few studies have examined the causes of syncope/collapse recurrences in patients with a previously implanted pacemaker for bradyarrhythmic syncope.

Objective: The purpose of this study was to assess the causes of syncope/collapse recurrences after pacemaker implantation for bradyarrhythmic syncope in a large patient population.

Methods: The SYNCOpal recurrences in patients treated with permanent PACing for bradyarrhythmic syncope (SYNCOPACED) registry was a prospective multicenter observational registry enrolling 1364 consecutive patients undergoing pacemaker implantation for bradyarrhythmic syncope. Read More

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Delayed management of atrial lead dislodgment after pacemaker implantation: a case report.

J Med Case Rep 2021 Jan 14;15(1). Epub 2021 Jan 14.

Department of Cardiology, Capital Medical University affiliated Beijing Shijitan Hospital, No 10 Tieyi Road, Haidian, Yangfangdian, Beijing, China.

Background: Pacemaker lead dislodgement may cause malfunction in the pacing system, which may lead to severe adverse events. For patients with sick sinus syndrome but normal atrioventricular conduction, atrial lead dislocation may cause excessive unnecessary ventricular pacing, resulting in nonphysiological pacing leading to heart failure. The longer the unwanted ventricular pacing continues, the greater the chances that irreversible heart failure may occur. Read More

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January 2021

Safety of lung stereotactic ablative radiotherapy for the functioning of cardiac implantable electronic devices.

Radiother Oncol 2021 03 30;156:193-198. Epub 2020 Dec 30.

Department of Oncology, University of Torino, Italy.

Background And Purpose: The prevalence of patients with a cardiac implantable device (CIED) developing cancer and requiring a course of radiotherapy (RT) is increasing remarkably. Previously published reports agree that standard and conventionally fractionated RT is usually safe for CIEDs, but no "in-vivo" reports are available on the potential effects of thoracic stereotactic ablative radiotherapy (SABR) regimens to CIEDs functioning. The purpose of our study is therefore to evaluate the effects of SABR on CIEDs (pacemakers [PM] or implantable cardiac defibrillators [ICD]) in a cohort of patients affected by primary or metastatic lung lesions. Read More

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Shortness of breath and palpitations in an elderly man: Bad device behavior or malfunction?

J Arrhythm 2020 Dec 17;36(6):1109-1111. Epub 2020 Oct 17.

Mount Sinai Morningside Icahn School of Medicine at Mount Sinai New York NY USA.

70-year-old male with sinus node dysfunction (SND) and paroxysmal atrial fibrillation presents with shortness of breath and palpitations. Presenting EKG shows AF with rapid ventricular rates requiring direct current cardioversion (DCCV). Post-DCCV EKG shows sinus rhythm with competing ventricular pacing. Read More

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December 2020

Late presentation of recurrent syncope after permanent pacemaker implantation due to Lead-Header malapposition.

Indian Pacing Electrophysiol J 2021 Mar-Apr;21(2):124-127. Epub 2020 Nov 30.

The University of Chicago Pritzker School of Medicine, Center for Arrhythmia Care, Heart and Vascular Center, Chicago, IL, USA.

Permanent pacemaker (PPM) malfunction due to electrical connection problems such as a loose set screw or lead-header malapposition is extremely rare. We present a patient with complete heart block (CHB) who had PPM malfunction and recurrent syncope, late (14 months) after initial implantation, which was caused by the ventricular lead pin disengagement from the header resulting in oversensing due to noise, pacing inhibition and recurrent syncope. PPM due to lead-header malapposition this late after device implantation has previously not been reported. Read More

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November 2020

False Asystole Alarms Post-Temporary Pacemaker Placement Due to Pseudo-fusion.

Pediatr Cardiol 2021 Jan 28;42(1):215-218. Epub 2020 Nov 28.

Department of Pediatrics, Rush University Medical Center, Chicago, IL, 60612, USA.

An infant with congenital heart block and hemodynamically significant bradycardia underwent therapeutic temporary pacing wires placement. Post-operatively, frequent "asystole" alarms were observed on telemetry causing distress to both the family and the nursing staff. Investigation of these alarms showed that pacemaker malfunction led to monitor pseudo-malfunction. Read More

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January 2021

The Footprints of Pacing Lead Position Using the 12-Lead Electrocardiograph.

Harry G Mond

Heart Lung Circ 2021 Mar 6;30(3):350-361. Epub 2020 Nov 6.

Department of Cardiology, The Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Vic, Australia; Cardioscan Pty Ltd, Melbourne, Vic, Australia. Electronic address:

The 12-lead resting electrocardiograph (ECG) of a patient with an implanted cardiac pacemaker is a snapshot of cardiac electrical activity at the time of recording and may provide valuable information on both pacemaker function and malfunction, as well as identifying the position of pacing leads in the heart. The traditional site for atrial pacing is within or adjacent to the right atrial appendage and paced P waves on the ECG have a normal frontal plane axis, whereas the traditional site for ventricular pacing is at the right ventricular apex with the ECG demonstrating a left bundle branch block configuration and a left axis. More recently, ventricular leads and to a lesser extent, atrial leads have been positioned in alternate non-traditional sites resulting in 12-lead ECG appearances which have characteristic features, that are generally poorly recognised. Read More

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[Pifalls in the interpretation of pacemaker ECGs].

Herzschrittmacherther Elektrophysiol 2020 Dec;31(4):345-361

Klinik für Innere Medizin - Kardiologie, Diabetologie & Nephrologie, Evangelisches Klinikum Bethel, Burgsteig 13, 33617, Bielefeld, Deutschland.

The analysis of the pacemaker ECG is usually regarded as difficult and may generate rather mediocre interpretations. It is a common opinion that a pacemaker ECG can only be analyzed if the type of pacemaker (single-, dual-, triple-chamber, manufacturer, model) and its programming are known. The following pitfalls illustrate how to achieve a clinically meaningful ECG interpretation in daily practice, even if these details are not known. Read More

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December 2020

Prospective analysis of a surgical algorithm to achieve ventilator weaning in cervical tetraplegia.

J Spinal Cord Med 2020 Oct 15:1-5. Epub 2020 Oct 15.

Division of Plastic and Reconstructive Surgery, David Geffen UCLA Medical Center, Los Angeles, California, USA.

Chronic ventilator dependency in cervical tetraplegia is associated with substantial morbidity. When non-invasive weaning methods have failed the primary surgical treatment is diaphragm pacing. Phrenic nerve integrity and diaphragm motor units are requirements for effective pacing but may need to be restored for successful weaning. Read More

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October 2020

Safe application of extensive radiotherapy to a cardiac resynchronization device.

ESC Heart Fail 2020 Oct 11. Epub 2020 Oct 11.

Department of Cardiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, A-5020, Austria.

Patients with cardiac implantable electronic devices undergoing radiotherapy (RT) are prone to the risk of device failure. Guidelines and manufacturer's instructions are lacking practical recommendations for cumulative radiation doses to pacemakers or implantable cardioverter defibrillators. The present case demonstrates the effect of RT of a Merkel cell carcinoma near the location of a cardiac resynchronization therapy pacemaker. Read More

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October 2020

Efficacy and safety of transvenous lead extraction using a liberal combined superior and femoral approach.

J Interv Card Electrophysiol 2020 Oct 7. Epub 2020 Oct 7.

Department of Cardiology, Erasmus MC, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands.

Purpose: During transvenous lead extraction (TLE), the femoral snare has mainly been used as a bail-out procedure. The purpose of the present study is to evaluate the efficacy and safety of a TLE approach with a low threshold to use a combined superior and femoral approach.

Methods: This is a single-center observational study including all TLE procedures between 2012 till 2019. Read More

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October 2020

[Unusual complication during pacemaker implantation].

Herzschrittmacherther Elektrophysiol 2020 Dec 7;31(4):434-436. Epub 2020 Oct 7.

St. Josefs-Hospital, Wiesbaden, Deutschland.

Bradycardic arrhythmias have a broad spectrum of symptoms which range from mild dizziness to cardiac syncope. Pacemaker therapy continues to be the cornerstone of treatment and can effectively treat symptoms. Despite an implanted cardiac pacemaker, patients may experience continued or even new symptoms. Read More

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December 2020

An innovative hybrid approach for detection of pacemaker pulses at low sampling frequency.

Annu Int Conf IEEE Eng Med Biol Soc 2020 07;2020:5012-5015

Accurate assessment of pacemaker function or malfunction is essential to make clinical interpretations on pacemaker therapy and patient symptoms. This article presents an innovative approach for detecting pacemaker pulses at sampling frequency as low as 125Hz. The proposed method is validated in wide range of simulated clinical ECG conditions such as arrhythmia (sinus rhythms, supraventricular rhythms, and AV blocks), pulse amplitudes (~100µV to ~3mV), pulse durations (~100µs to ~2ms), pacemaker modes and types (fixed-rate or on-demand single chamber, dual chamber, and bi-ventricular pacing), and physiological noise (tremor). Read More

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Transvenous extraction of pacemaker leads via femoral approach using a gooseneck snare.

Herz 2021 Feb 2;46(1):82-88. Epub 2020 Oct 2.

Faculty of Medicine, Cardiology Department, Marmara University, Istanbul, Turkey.

Background: The growing problem of endocardial lead infections and lead malfunctions has increased interest in percutaneous lead-removal technology. Transvenous lead extraction (TLE) via simple manual traction (SMT) is the first-line therapy. When SMT is not successful, TLE from the femoral vein using a gooseneck snare (GS) with a radiofrequency ablation catheter (RFAC) may be an alternative option. Read More

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February 2021

Leadless pacemaker implantation under direct visualization during valve surgery.

J Thorac Cardiovasc Surg 2020 Aug 6. Epub 2020 Aug 6.

Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

Objective: The leadless cardiac pacemaker is typically implanted percutaneously and has been widely used for patients who have already undergone valve surgery. We sought to determine the feasibility and safety of implanting the leadless pacemaker under direct visualization during valve surgery.

Methods: We performed a retrospective analysis of consecutive adult patients (n = 15) who underwent implantation of a leadless pacemaker under direct visualization at the time of valve surgery. Read More

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Targeted Intraoperative Radiotherapy Is a Safe Approach for Patients with Pacemakers: A Case Study and Literature Review.

Case Rep Oncol 2020 May-Aug;13(2):916-922. Epub 2020 Jul 30.

Department of Surgery, Glendale Adventist Medical Center, Glendale, California, USA.

Case reports detailing the effects of targeted intraoperative radiation therapy (IORT) on patients with cardiac pacemakers (PMs) are rare. This growing population sub-group requiring IORT and lack of standardized guidelines necessitate more practical published research. An 81-year-old patient with clinical stage II, T1 N0 grade III, triple-negative invasive ductal carcinoma and an implanted single-lead chamber PM (VVIR mode, model: Biotronik, type Effecta SR) received targeted intraoperative radiotherapy at the time of wide local excision and sentinel lymph node biopsy. Read More

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Electromagnetic interference on cardiac pacemakers and implantable cardioverter defibrillators during endoscopy as reported to the US Federal Drug Administration.

Surg Endosc 2020 Aug 17. Epub 2020 Aug 17.

Rocky Mountain Regional Veterans Affairs Medical Center, University of Colorado, 1700 North Wheeling St, Mail Stop 112, Aurora, CO, 80045, USA.

Introduction: More than 3 million patients have a cardiac implanted electronic device (CIED) such as a pacemaker or implanted cardioverter-defibrillator in the USA. These devices are susceptible to electromagnetic interference (EMI) leading to malfunction and injury. Radiofrequency energy, the most common modality for obtaining hemostasis during endoscopy, is the most common source of EMI. Read More

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Intermittent Pacemaker Malfunction Caused by Continuous Compression of the Lead by the Clavicle (Subclavian Crush Syndrome).

Eur J Case Rep Intern Med 2020 27;7(8):001684. Epub 2020 May 27.

Cardiology Department, Ansari Saleh General Hospital Banjarmasin, Indonesia.

Subclavian vein access is still one of the most favoured access options for cardiac implantable electronic device (CIED) implantation. For the physician, the technique is reasonably familiar and easy to carry out. However, this has several potential complications. Read More

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Diaphragm pacing in a pediatric patient with Acquired Central Hypoventilation syndrome.

Rev Chil Pediatr 2020 Apr;91(2):255-259

Centro de Responsabilidad Infantil, Hospital Clínico de Magallanes, Chile.

Introduction: Diaphragmatic pacemaker is a device that reduces or eliminates the need of mechanical ventilation in patients with chronic respiratory failure who keep the phrenic nerve-diaphragm axis intact, as long as they do not present intrinsic lung disease. Although its implantation has been practiced for deca des, its use is not widespread and to date, there is little published literature about it, mostly related to high spinal cord injury and congenital central hypoventilation syndrome.

Objective: To describe an experience of diaphragmatic pacemaker implantation in a pediatric patient with acquired cen tral hypoventilation syndrome. Read More

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Reversible bradycardia secondary to myxedema coma: case-report.

Rev Cardiovasc Med 2020 Jun;21(2):297-301

Division of Cardiology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA.

Myxedema coma occurs mostly in patients with long-standing untreated or undertreated hypothyroidism. Bradycardia is a well-known cardiac manifestation for myxedema coma; however, not all bradycardia with hypothyroidism are sinus bradycardia. Sick sinus syndrome is a group of arrhythmias caused by the malfunction of the natural pacemaker of the heart. Read More

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Safety of bioelectrical impedance analysis in advanced heart failure patients.

Pacing Clin Electrophysiol 2020 10 31;43(10):1078-1085. Epub 2020 Jul 31.

Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Background: Cardiac cachexia and frailty are major complications of advanced heart failure (AHF). Bioelectrical impedance analysis (BIA) may provide valuable information regarding fluid balance, muscle mass and prognosis. The main concerns regarding the use of BIA in AHF patients remain arrhythmias and electromagnetic interferences with cardiac implantable electronic devices (CIEDs). Read More

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October 2020

Radiotherapy in Patients With a Cardiac Implantable Electronic Device.

Am J Cardiol 2020 08 15;128:196-201. Epub 2020 May 15.

Unité de Rythmologie, Département de Cardiologie, Hôpital Européen Georges Pompidou, Paris, France; Université de Paris, PARCC, INSERM, F-75015 Paris, France. Electronic address:

Recently, the Heart Rhythm Society published recommendations on management of patients with cardiac implantable electronic device (CIED) who require radiotherapy (RT). We aimed to report the experience of a teaching hospital, and discuss our practice in the context of recently published guidelines. We identified all consecutive CIED recipients (12,736 patients) who underwent RT between March 2006 and June 2017. Read More

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