Open AccessInappropriate mode switching clarified by using a chest radiograph
Author(s) -
Marino Brian,
Jaiswal Abhishek,
Goldbarg Seth
Publication year - 2015
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2015.01.001
Subject(s) - medicine , cardiology , chest radiograph , atrial fibrillation , lead (geology) , paroxysmal atrial fibrillation , geomorphology , lung , geology
An 80‐year‐old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post‐dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.