Open AccessWhat is the mechanism of irregular pacing spikes? Pacing failure, sensing failure, or something else? A case report
Author(s) -
Gaku Oguri,
Tadao Kojima,
Katsuhito Fujiu,
Issei Komuro
Publication year - 2020
Publication title -
european heart journal. case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.256
H-Index - 5
ISSN - 2514-2119
DOI - 10.1093/ehjcr/ytaa065
Subject(s) - presyncope , medicine , cardiac pacing , qrs complex , heart failure , cardiology , heart rate , blood pressure
Background In cardiac implantable electronic device management, confused electrocardiograms are sometimes encountered. Case summary We experienced a case of dizziness and presyncope, which was accompanied by irregular pacing spikes following QRS complexes, pacing failure, sensing failure, or something else. The patient’s second active pacemaker in her left chest was functioning normally. However, her old abdominal pacemaker had automatically changed from the OVO to VVI mode because of an elective replacement indicator. As a result, her old and second pacemakers had an interaction. Old invalid pacing spikes induced oversensing of the current pacemaker, which interfered with valid pacing. Discussion We experienced a rare case of dizziness and presyncope with confused pacing spikes. Physicians should be aware of the unexpected interactions that are possible with devices with automatic mode changes.