Why the study?
Does reprogramming to bipolar pacing/sensing restore ventricular capture in a patient with suspected right ventricular perforation by a pacemaker lead?
Does reprogramming to bipolar pacing/sensing restore ventricular capture in a patient with suspected right ventricular perforation by a pacemaker lead?
Reprogramming a pacemaker to bipolar pacing can provide effective anodal stimulation from the ring electrode to restore ventricular capture in cases of lead tip perforation.
Answers are grounded in this paper and cite their sources.
May offer noninvasive capture restoration in suspected perforation; hypothesis-generating case observation needing prospective validation.
This report describes the case of an 86-year-old male with syncopal paroxysmal 2:1 atrioventricular block and a single chamber VVI pacemaker programmed to bipolar sensing and unipolar pacing. After recurrence of syncope, a complete loss of ventricular capture with regular ventricular sensing was observed on ECG; fluoroscopic examination suggested perforation of the right ventricle by the helix of the implanted screw-in lead. Reprogramming the pacemaker to bipolar pacing/sensing resulted in regular ventricular capture and sensing, suggesting effective anodal stimulation from the ring electrode permitting complete non-invasive palliation.
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Occhetta et al. (2006) studied this question.
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