Dual-chamber leadless pacing with a retained malfunctioning right ventricular lead caused recurrent syncope with pauses up to 13 seconds, which resolved for 12 months after reprogramming to VDD.
Case Report (n=1)
Can a retained malfunctioning right ventricular lead cause ventricular pacing inhibition after dual-chamber leadless pacemaker implantation?
Retained malfunctioning leads may mediate timing-dependent ventricular inhibition after dual-chamber leadless pacing, highlighting the need for careful programming and monitoring in such patients.
An 88-year-old pacemaker-dependent man with a retained low-impedance, noise-producing right ventricular lead underwent implantation of a dual-chamber leadless pacemaker. On postoperative day 1, he developed recurrent syncope with pauses up to 13 s. Although stored electrograms from the index events were unavailable, post-event interrogation showed atrial pacing followed by ventricular safety pacing, and provocative testing supported persistent electrical coupling involving the retained lead. After reduction of temporary high-output settings and reprogramming to VDD, syncope did not recur during 12 months. Retained malfunctioning leads may mediate timing-dependent ventricular inhibition after dual-chamber leadless pacing.
Nakamura et al. (Mon,) conducted a case report in Pacemaker-dependent with a retained right ventricular lead (n=1). Dual-chamber leadless pacemaker implantation and reprogramming to VDD was evaluated on Recurrent syncope. Dual-chamber leadless pacing with a retained malfunctioning right ventricular lead caused recurrent syncope with pauses up to 13 seconds, which resolved for 12 months after reprogramming to VDD.