Key result
A continuous ambulatory ECG monitor successfully diagnosed intermittent epicardial lead failure that had gone undetected by standard remote transmissions and in-office device interrogations.
Why the study?
Does a continuous ambulatory ECG monitor detect intermittent epicardial lead failure in a patient with symptoms missed by standard device interrogations?
Case Report (n=1)
Does a continuous ambulatory ECG monitor detect intermittent epicardial lead failure in a patient with symptoms missed by standard device interrogations?
Continuous ambulatory ECG monitoring can be a useful diagnostic tool for detecting intermittent pacemaker lead failure when standard device interrogations are unrevealing.
Answers are grounded in this paper and cite their sources.
May facilitate diagnosis of intermittent lead failure missed by remote monitoring in symptomatic patients; leaves open broader utility pending prospective trials.
A 69-year-old man received epicardial pacing leads for complete atrioventricular block that occurred during a mechanical tricuspid valve replacement procedure. During follow-up, the patient reported intermittent episodes of dizziness and bradycardia. Remote transmissions and device interrogations failed to elucidate the cause of his symptoms. A continuous ambulatory electrocardiogram (ECG) monitor was used as an alternative diagnostic tool. Multiple pauses were detected by the monitor and, upon review, these events were deemed to be due to the intermittent loss of capture by the epicardial lead. Once this diagnosis was made and the malfunctioning lead was replaced, the patient's symptoms resolved. This case highlights the novel use of a continuous ambulatory ECG monitor in diagnosing intermittent loss of capture, which was not detected by remote monitoring or device interrogations.
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Gabriels et al. (2021) conducted a case report in Intermittent epicardial lead failure (n=1). Continuous ambulatory electrocardiogram monitor (ZIO XT Patch) vs. Remote monitoring and in-office interrogations was evaluated on Detection of the cause of intermittent dizziness and bradycardia. A continuous ambulatory ECG monitor successfully diagnosed intermittent epicardial lead failure that had gone undetected by standard remote transmissions and in-office device interrogations.
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