Ohe H, Oginosawa Y, Yamagishi Y, Miyamoto T, Tsukahara K, Kohno R, Abe H, Otsuji Y. Rate-dependent pacing failure after pacemaker implantation: Novel insights into the mechanism of using adenosine.
J Cardiovasc Electrophysiol 2020;
31:2765-2769. [PMID:
32757423 DOI:
10.1111/jce.14704]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 11/27/2022]
Abstract
An 82-year-old woman received pacemaker implantation for sick sinus syndrome. Two days after the implantation, electrocardiography showed 2:1 atrial pacing failure, followed by a bradycardia-dependent increase in the atrial pacing threshold during a pacemaker examination. However, transient 1:1 atrial pacing capture recovered by adenosine triphosphate (ATP) administration, which was performed to evaluate the bradycardia-dependent pacing failure mechanism. We considered this phenomenon to be caused by Phase 4 depolarization and avoided replacing this atrial lead. Three weeks later, the atrial pacing threshold had improved. We report the potential role of Phase 4 depolarization in a bradycardia-dependent increase in pacing threshold by using ATP.
Collapse