title: Transient loss of sensing and capture during coronary angiography in two patients with permanent pacemakers.
abstract: Two cases of transient pacemaker failure to sense and capture during angiography are reported. This phenomenon is due to a transient increase in sensing and pacing thresholds beyond the pacemakers programmed settings. The underlying mechanism may be related to blood displacement, the electrochemical properties of the injectate, the high concentration of the contrast media, or a combination of these properties. Even though the chambers in which sensing and pacing loss occurred differed (ventricle in the first and atria in the second), the episode occurred repeatedly after injection of contrast media into the artery supplying the respective electrode-tissue interface. In pacemaker dependent patients, provisions for external pacing should be implemented prior to injection of contrast into the coronary arteries.
authors.affiliation: University of Southern California, Division of Cardiology, USC/LAC Medical Center.
authors.forename: G Y
authors.initials: GY
authors.lastname: Perry
authors.forename: V
authors.initials: V
authors.lastname: Parsonnet
authors.forename: R
authors.initials: R
authors.lastname: Werres
authors.forename: N C
authors.initials: NC
authors.lastname: Flowers
mesh_terms: D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects*
chemical_list: D003287:Contrast Media