Unexpected loss of atrial tracking caused by interaction between temporary and permanent right ventricular leads during implantation of a biventricular pacemaker.
This report describes a patient who underwent implantation of an atriobiventricular pacemaker following AV junction ablation and insertion of a temporary right ventricular (RV) pacemaker. During implantation, intermittent loss of sinus P wave tracking occurred when the three permanent leads were connected to the generator. Analysis of marker annotation disclosed intermittent abnormal ventricular sensing that reinitiated postventricular atrial blanking and caused failure of P wave tracking. This phenomenon disappeared after removing the temporary RV lead, but not by turning off the temporary pacemaker. We assume that mechanical contact between the temporary and the permanent RV leads is the underlying mechanism.
Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. kcc45@ms36.hinet.net
Kuan-Cheng
KC
Chang
Jan-Yow
JY
Chen
Jen-Jyh
JJ
Lin
Jui-Sung
JS
Hung
D000368:Aged; D017115:Catheter Ablation; D004562:Electrocardiography; D004567:Electrodes, Implanted / Q000009:adverse effects; D005260:Female; D006325:Heart Atria; D006327:Heart Block / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects