title: Runaway pulse generator malfunction resulting from undetected battery depletion.
abstract: Runaway pacemaker is an uncommon, potentially lethal circuit malfunction characterized by sudden onset of erratic pacing at rapid nonphysiological rates. Two patients with a single chamber pacemaker (Medtronic ST 8331 and 8419) presented with episodic dizziness. ECG revealed recurrent decrescendo amplitude episodes of runaway stimuli at 2,400 and 2,600 ppm, approximately 3 seconds in duration, separated by pacing at 62.5 and 65 ppm, respectively. Fortunately the runaway stimuli were subthreshold and did not result in capture of the ventricle. Emergency pulse generator replacement was uneventful. Both leads were normal and both pulse generators had low battery voltages at 1.488 and 1.78 V, respectively.
authors.affiliation: Cardiovascular Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10467, USA.
authors.forename: Pugazhendhi
authors.initials: P
authors.lastname: Vijayaraman
authors.forename: Kedarnath
authors.initials: K
authors.lastname: Vaidya
authors.forename: Soo G
authors.initials: SG
authors.lastname: Kim
authors.forename: Jay N
authors.initials: JN
authors.lastname: Gross
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Ferrick
authors.forename: Eugen
authors.initials: E
authors.lastname: Palma
authors.forename: Seymour
authors.initials: S
authors.lastname: Furman
authors.forename: John D
authors.initials: JD
authors.lastname: Fisher
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D011211:Electric Power Supplies; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial