Cardiac pacemaker battery discharge after external electrical cardioversion for broad QRS Complex Tachycardia.
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.
Annamaria
Martino
M
Krannert Institute of Cardiology, Indiana University, Indianapolis IN 46202, USA.
Andrea
Scapigliati
S
Michela
Casella
C
Tommaso
Sanna
S
Gemma
Pelargonio
P
Antonio
Dello Russo
DR
Roberto
Zamparelli
Z
Stefano
De Paulis
de P
Fulvio
Bellocci
B
Rocco
Schiavello
S