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Chae MS, Lee N, Koh HJ. Sudden Occurrence of Pacemaker Capture Failure during Irreversible Electroporation Ablation for Prostate Cancer in Post-COVID-19 Patient: A Case Report. Medicina (B Aires) 2022; 58:medicina58101407. [PMID: 36295568 PMCID: PMC9607448 DOI: 10.3390/medicina58101407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 11/16/2022] Open
Abstract
Irreversible electroporation (IRE) ablation is a novel treatment option for localized prostate cancer. Here, we present a case of an abrupt and fatal arrhythmia during the IRE procedure in a prostate cancer patient with an implanted permanent pacemaker. A 78-year-old male patient with a pacemaker due to sick sinus syndrome and syncope was scheduled for IRE prostate ablation surgery under general anesthesia. He had a history of recovering from coronavirus disease 2019 (COVID-19) after having been vaccinated against it and recovered without sequalae. Pacemaker interrogation and reprogramming to asynchronous AOO mode was carried out before surgery, however, sinus pause occurred repeatedly during ablation pulse delivery. After the first sinus pause of 2.25 s there was a decrease in continuous arterial blood pressure (ABP). During the delivery of the second and third pulses, identical sinus pauses were observed due to failure to capture. However, the atrial-paced rhythm recovered instantly, and vital signs became acceptable. Although sinus pause recovered gradually, the duration thereof was increased by the delivery of more IRE pulses, with a subsequent abrupt decrease seen in blood pressure. The pacemaker was urgently reprogrammed to DOO mode, after which there were no further pacing failures and no hemodynamic adverse events. For patients with pacemakers, close cardiac monitoring in addition to the interrogation of the pacemaker during the electromagnetic interference (EMI) procedure is recommended, especially in the case of having a disease that may aggravate cardiac vulnerability, such as COVID-19.
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Affiliation(s)
| | | | - Hyun Jung Koh
- Correspondence: ; Tel.: +82-2-2258-6156; Fax: +82-2-537-1951
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Pedretti RFE, Iliou MC, Israel CW, Abreu A, Miljoen H, Corrà U, Stellbrink C, Gevaert AB, Theuns DA, Piepoli MF, Reibis R, Schmid JP, Wilhelm M, Heidbuchel H, Völler H. Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA). Europace 2021; 23:1336-1337o. [PMID: 33636723 DOI: 10.1093/europace/euaa427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/25/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme. This is not only related to the underlying heart disease but also to specific issues, such as psychological adaptation to living with an implanted device and, in implantable cardioverter-defibrillator patients, the risk of arrhythmia, syncope, and sudden cardiac death. Therefore, these patients should receive special attention, as their needs may differ from other patients participating in CR. As evidence from studies of CR in patients with cardiac implantable electronic devices is sparse, detailed clinical practice guidelines are lacking. Here, we aim to provide practical recommendations for CR in cardiac implantable electronic devices recipients in order to increase CR implementation, efficacy, and safety in this subset of patients.
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Affiliation(s)
- Roberto F E Pedretti
- Cardiovascular Department, IRCCS MultiMedica, Care and Research Institute, Via Milanese 300, Sesto San Giovanni, Milano 20099, Italy
| | - Marie-Christine Iliou
- Department of Cardiac Rehabilitation and Secondary Prevention, Hôpital Corentin Celton, Assistance Pulique Hopitaux de Paris centre-Universite de Paris, France
| | - Carsten W Israel
- Department of Cardiology, Bethel Clinic, J.W. Goethe University, Frankfurt, Germany
| | - Ana Abreu
- Servico de Cardiologia, Hospital Universitário de Santa Maria/Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Academico de Medicina de Lisboa (CAML), Centro Cardiovascular da Universidade de Lisboa (CCUL), Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Hielko Miljoen
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, Antwerp, Belgium
| | - Ugo Corrà
- Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Veruno, Novara, Italy
| | - Christoph Stellbrink
- Department of Cardiology and Intensive Care Medicine, Klinikum Bielefeld GmbH, Bielefeld, Germany
| | - Andreas B Gevaert
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, Antwerp, Belgium
| | - Dominic A Theuns
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
| | - Rona Reibis
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.,Cardiac Outpatient Clinic Am Park Sanssouci, Potsdam, Germany
| | - Jean Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hein Heidbuchel
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, Antwerp, Belgium
| | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.,Klinik am See, Rehabilitation Centre for Internal Medicine, Rüdersdorf, Germany
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Pedretti RFE, Iliou MC, Israel CW, Abreu A, Miljoen H, Corrà U, Stellbrink C, Gevaert AB, Theuns DA, Piepoli MF, Reibis R, Schmid JP, Wilhelm M, Heidbuchel H, Völler H, Ambrosetti M, Deneke T, Cornelissen V, R Heinzel F, Davos CH, Kudaiberdieva G, Frederix I, Svendsen JH, Hansen D. Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA). Eur J Prev Cardiol 2021; 28:1736-1752. [PMID: 34038513 DOI: 10.1093/eurjpc/zwaa121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/25/2020] [Accepted: 11/02/2020] [Indexed: 12/13/2022]
Abstract
Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme. This is not only related to the underlying heart disease but also to specific issues, such as psychological adaptation to living with an implanted device and, in implantable cardioverter-defibrillator patients, the risk of arrhythmia, syncope, and sudden cardiac death. Therefore, these patients should receive special attention, as their needs may differ from other patients participating in CR. As evidence from studies of CR in patients with cardiac implantable electronic devices is sparse, detailed clinical practice guidelines are lacking. Here, we aim to provide practical recommendations for CR in cardiac implantable electronic devices recipients in order to increase CR implementation, efficacy, and safety in this subset of patients.
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Affiliation(s)
- Roberto F E Pedretti
- Cardiovascular Department, IRCCS MultiMedica, Care and Research Institute, Via Milanese 300, Sesto San Giovanni, Milano 20099, Italy
| | - Marie-Christine Iliou
- Department of Cardiac Rehabilitation and Secondary Prevention, Hôpital Corentin Celton, Assistance Pulique Hopitaux de Paris centre-Universite de Paris, France
| | - Carsten W Israel
- Department of Cardiology, Bethel Clinic, J.W. Goethe University, Frankfurt, Germany
| | - Ana Abreu
- Servico de Cardiologia, Hospital Universitário de Santa Maria/Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Academico de Medicina de Lisboa (CAML), Centro Cardiovascular da Universidade de Lisboa (CCUL), Faculdade de Medicina, Universidade de Lisboa, Portugal
| | - Hielko Miljoen
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, and Antwerp University, Antwerp, Belgium
| | - Ugo Corrà
- Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Veruno, Novara, Italy
| | - Christoph Stellbrink
- Department of Cardiology and Intensive Care Medicine, Klinikum Bielefeld GmbH, Bielefeld, Germany
| | - Andreas B Gevaert
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, and Antwerp University, Antwerp, Belgium
| | - Dominic A Theuns
- Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
| | - Rona Reibis
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.,Cardiac Outpatient Clinic Am Park Sanssouci, Potsdam, Germany
| | - Jean Paul Schmid
- Department of Cardiology, Clinic Barmelweid, Erlinsbach, Switzerland
| | - Matthias Wilhelm
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hein Heidbuchel
- Department of Cardiology, University of Antwerp and University Hospital Antwerp, and Antwerp University, Antwerp, Belgium
| | - Heinz Völler
- Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany.,Klinik am See, Rehabilitation Centre for Internal Medicine, Rüdersdorf, Germany
| | | | - Marco Ambrosetti
- Cardiovascular Rehabilitation Unit, ASST Crema, Santa Marta Hospital, Rivolta d'Adda, Italy
| | - Thomas Deneke
- Heart Center Rhön-Klinikum Campus Bad Neustadt, Bad Neustadt, Germany
| | - Veronique Cornelissen
- Cardiovascular Exercise Physiology Unit, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Frank R Heinzel
- Department of Cardiology, Charité-Universitaetsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Constantinos H Davos
- Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - Gulmira Kudaiberdieva
- SRI of Heart Surgery and Organ Transplantation, Center Scientific Research and Development of Education, Bishkek Kyrgyzstan, Adana, Turkey
| | - Ines Frederix
- Hasselt University, Faculty of Medicine & Life Sciences, Hasselt, Belgium.,Antwerp University, Faculty of Medicine & Health Sciences, Antwerp, Belgium.,Department of Cardiology, Jessa Hospital, Hasselt, Belgium.,Intensive Care Unit, Antwerp University Hospital, Edegem, Belgium
| | - Jesper Hastrup Svendsen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Dominique Hansen
- Heart Centre Hasselt, Jessa Hospital, Hasselt, Belgium.,Faculty of Medicine and Life Sciences, UHasselt, BIOMED-REVAL-Rehabilitation Research Centre, Hasselt University, Hasselt, Belgium
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