Key result
Suspected post-pacemaker ventricular lead dislodgement represents coincidental ECG artifact rather than true device malfunction.
Why the study?
Post-implantation electrocardiographic artifacts can mimic pacemaker lead dislodgement, complicating device function assessment.
Case Report (n=1)
Familiarity with device manufacturer pacing algorithms and electrocardiographic artifacts is crucial to avoid misdiagnosing normal pacemaker function as lead dislodgement or device malfunction.
CASE SUMMARY: A patient presents with symptomatic bradycardia and high-grade atrioventricular block and receives a dual-chamber pacemaker with left bundle branch area pacing lead. Post procedure, there is concern for dislodgement of the ventricular lead after an electrocardiogram shows a missing ventricular paced beat. After additional device interrogation and review of the device manufacturer algorithms, it was determined that what was thought to be loss-of-capture or loss-of-sensing was coincidental artifact and normal device function. TAKE-HOME MESSAGES: The highest risk for pacemaker lead dislodgement is immediately after implantation, and a 12-lead electrocardiogram should be reviewed post implantation. Understanding device manufacturer algorithms can help interpret unusual artifacts and findings in paced rhythms.
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Shah et al. (2026) conducted a case report in Symptomatic bradycardia and high-grade atrioventricular block (n=1). Dual-chamber pacemaker with left bundle branch area pacing lead was evaluated. A suspected ventricular lead dislodgement post-pacemaker implantation was determined to be coincidental electrocardiographic artifact rather than loss-of-capture or loss-of-sensing.
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