title: Cardiac pacemaker battery discharge after external electrical cardioversion for broad QRS Complex Tachycardia.
abstract: External electrical cardioversion or defibrillation may be necessary in patients with implanted cardiac pacemaker (PM) or implantable cardioverter defibrillator (ICD). Sudden discharge of high electrical energy employed in direct current (DC) transthoracic countershock may damage the PM/ICD system resulting in a series of possible device malfunctions. For this reason, when defibrillation or cardioversion must be attempted in a patient with a PM or ICD, some precautions should be taken, particularly in PM dependent patients, in order to prevent damage to the device. We report the case of a 76-year-old woman with a dual chamber PM implanted in the right subclavicular region, who received two consecutive transthoracic DC shocks to treat haemodynamically unstable broad QRS complex tachycardia after cardiac surgery performed with a standard sternotomic approach. Because of the sternal wound and thoracic drainage tubes together with the severe clinical compromise, the anterior paddle was positioned near the pulse generator. At the following PM test, a complete battery discharge was detected.
authors.affiliation: Krannert Institute of Cardiology, Indiana University, Indianapolis IN 46202, USA.
authors.forename: Martino
authors.initials: M
authors.lastname: Annamaria
authors.forename: Scapigliati
authors.initials: S
authors.lastname: Andrea
authors.forename: Casella
authors.initials: C
authors.lastname: Michela
authors.forename: Sanna
authors.initials: S
authors.lastname: Tommaso
authors.forename: Pelargonio
authors.initials: P
authors.lastname: Gemma
authors.forename: Dello Russo
authors.initials: DR
authors.lastname: Antonio
authors.forename: Zamparelli
authors.initials: Z
authors.lastname: Roberto
authors.forename: De Paulis
authors.initials: de P
authors.lastname: Stefano
authors.forename: Bellocci
authors.initials: B
authors.lastname: Fulvio
authors.forename: Schiavello
authors.initials: S
authors.lastname: Rocco