Key result
DC cardioversion is linked to pulse generator damage and increased stimulation thresholds in permanent pacemakers.
Why the study?
The safety and effects of external electrical cardioversion on patients with permanent pacemaker systems for termination of atrial fibrillation are uncertain.
Does direct current cardioversion cause pacemaker and/or electrode dysfunction in patients with permanent pacemaker systems?
Case Report (n=3)
Does direct current cardioversion cause pacemaker and/or electrode dysfunction in patients with permanent pacemaker systems?
Direct current cardioversion can cause significant damage to permanent pacemaker systems, including pulse generator damage and increased stimulation thresholds.
Alerts clinicians to potential pacemaker damage from DC cardioversion; single case leaves open incidence and prevention strategies.
Use of pacing in sick sinus syndrome and recent developments in pacemaker therapy for intermittent atrial fibrillation raise the question of whether external electrical cardioversion should be used for termination of atrial fibrillation. This paper analyzes three cases of pacemaker and/or electrode dysfunction appearing after direct current (DC) cardioversion for termination of atrial fibrillation. Despite similar conditions during cardioversion in all cases, different dysfunctions reflecting damage to the pulse generator and/or a rise of the stimulation threshold in both, atrial and ventricular leads, have been observed. The possible mechanisms for these effects are discussed and recommendations for the management of cardioversion in patients with permanent pacemaker systems are given.
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Waller et al. (2004) conducted a case report in Atrial fibrillation in patients with permanent pacemakers (n=3). Direct current (DC) cardioversion was evaluated on Pacemaker and/or electrode dysfunction. Direct current cardioversion in patients with permanent pacemakers can result in pulse generator damage and increased stimulation thresholds in both atrial and ventricular leads.
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