Key result
Synchronized DC countershock caused a non-programmable demand pacemaker to function in R-wave triggered mode instead of R-wave inhibited mode and reduced its output voltage by half.
Case Report (n=1)
Transthoracic countershock can cause subtle but significant damage to pacemaker circuitry, necessitating careful post-shock interrogation.
Post-shock pacemaker interrogation may be prudent; this case leaves open vulnerability in programmable devices.
Electrical cardioversion or defibrillation may be necessary in patients with implanted artificial cardiac pacemakers. Sudden discharge of high electrical energy employed in DC transthoracic countershock procedures may damage the sensitive pacemaker circuitry and result in malfunction. We report a case in which, following synchronized DC countershock, a non-programmable demand pacemaker functioned in the R-wave triggered mode rather than the R-wave inhibited mode as designed. Further, the pacemaker output voltage was reduced to about half its specified output. Such a malfunction may not be readily apparent, and requires careful analysis following electric shock.
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Das et al. (1981) conducted a case report in Pacemaker malfunction (n=1). Synchronized DC countershock was evaluated on Pacemaker malfunction. Synchronized DC countershock caused a non-programmable demand pacemaker to function in R-wave triggered mode instead of R-wave inhibited mode and reduced its output voltage by half.
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