This case series describes the occurrence and mechanisms of pacemaker-ventricular and ventricular-pacemaker blocks in patients with severe ischemic heart disease and heart failure.
Pacemaker block may complicate endocardial pacing in severe HF with IHD; leaves open incidence and clinical consequences.
Three patients are presented with pacemaker‐ventricular (P‐V) or ventricular‐pacemaker (V‐P) block. All patients had ischemic heart disease and severe heart failure and were treated with transvenous endocardial pacing because of high degree AV block and periods of asystole. One patient had a 1st degree P‐V block for several days before the endocardial electrode was replaced and the P‐V block disappeared. Another patient was in the terminal phase of an acute myocardial infarction when she developed a 1st degree V‐P block. The retrograde latency in the conventional leads corresponded to the time difference between a bipolar intra‐ventricular and a bipolar precordial lead. The third patient was in the terminal phase of myocardial failure when he developed 1st degree P‐V block followed by 2nd degree P‐V block type I and type II and finally high degree P‐V block. The mechanism of P‐V blocks is discussed.
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Forssell et al. (1974) studied this question.
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