Key result
Sequential placement of a bipolar VVI pacemaker and an AICD resulted in an energy-related failure to capture of the pacer in the post-shock period during defibrillation threshold testing.
Why the study?
Does AICD discharge affect pacemaker capture in patients with both a pacemaker and an AICD?
Case Report (n=1)
Does AICD discharge affect pacemaker capture in patients with both a pacemaker and an AICD?
AICD discharge can cause a transient, energy-dependent loss of pacemaker capture, highlighting the need for careful design and testing in patients with combined devices.
Answers are grounded in this paper and cite their sources.
Potential post-shock capture loss warrants caution in dual-device patients; leaves open whether routine testing detects all interactions.
A 78-year-old man treated with amiodarone for recurrent ventricular tachycardia, had sequential placement of a bipolar VVI pacemaker and an automatic implantable cardioverter defibrillator (AICD). During defibrillation threshold testing, there was failure to capture of the pacer in the post-shock period. The time of failure to capture appeared energy-related: the greater the energy delivered, the longer the failure to capture. Careful attention will be necessary in constructing combined AICD/pacemaker units.
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Slepian et al. (1987) conducted a case report in Recurrent ventricular tachycardia (n=1). Sequential placement of a bipolar VVI pacemaker and an AICD was evaluated on Failure to capture of the pacer in the post-shock period during defibrillation threshold testing. Sequential placement of a bipolar VVI pacemaker and an AICD resulted in an energy-related failure to capture of the pacer in the post-shock period during defibrillation threshold testing.
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