PMID: 6195601Sep 1, 1983Paper

False inhibition of an atrial demand pacemaker caused by an insulation defect in a polyurethane lead

Pacing and Clinical Electrophysiology : PACE
L M van Gelder, M I el Gamal

Abstract

A patient who had an atrial demand pacemaker (AAI) presented with irregular pacing at a routine examination 5 months after implantation. When a magnet was applied over the pulse generator regular fixed rate pacing was obtained, thus proving oversensing in the system. Reprogramming the input sensitivity level to 2.5 and 5.0 mV did not solve the problem. Programming the pulse generator to the triggered mode (AAT) showed acceleration of the stimulation rate but also inhibition of the system. An S-S interval of 1260 ms was measured at a programmed interval of 857 ms (70 bpm). The pulse generator was disconnected and the intra-atrial electrogram was recorded. This showed different spurious signals varying in morphology and amplitude. Fortunately we were able to remove the lead (Medtronic 6991-U) from the atrial appendage. Subsequently a Helifix 12 mm AT lead was successfully implanted in the right atrial appendage and the same pulse generator was connected to the newly implanted lead. When the removed lead was examined by the manufacturer, a small tear in the insulation of the wire was detected. The dimensions of the tear were 0.1 X 0.7 mm. The tear was caused by stress corrosion cracking in the polyurethane tubing of the lead.

References

Jan 1, 1978·Pacing and Clinical Electrophysiology : PACE·M YokoyamaM Grechko
Mar 1, 1979·Pacing and Clinical Electrophysiology : PACE·M El Gamal, B M van Gelder
Jul 1, 1977·Chest·S Furman, V De Caprio
May 1, 1977·American Heart Journal·S Furman
Oct 1, 1977·Circulation·S S BaroldR A Heinle
Jan 1, 1974·British Heart Journal·O J OhmE Waerness
Feb 1, 1972·Circulation·W D WidmannF M Dolan
Jun 1, 1971·The American Journal of Cardiology·R G CrystalR W DeSanctis
May 18, 1970·JAMA : the Journal of the American Medical Association·G R KingR A Carleton
Mar 1, 1981·Pacing and Clinical Electrophysiology : PACE·H G Mond, J G Sloman
Mar 1, 1981·Pacing and Clinical Electrophysiology : PACE·P A Levine, F A Pirzada
Mar 1, 1981·Pacing and Clinical Electrophysiology : PACE·S S Barold
Jul 1, 1981·Pacing and Clinical Electrophysiology : PACE·R G Hauser, A Susmano
May 1, 1981·Pacing and Clinical Electrophysiology : PACE·S S Barold, P A Levine
May 1, 1981·Pacing and Clinical Electrophysiology : PACE·L M Edwards, R G Hauser

Citations

Jul 1, 1985·Pacing and Clinical Electrophysiology : PACE·F BeyersdorfP Satter
Jul 1, 1986·Pacing and Clinical Electrophysiology : PACE·D S HubbellR G Zoble
Nov 1, 1986·Pacing and Clinical Electrophysiology : PACE·F A PirzadaM Killian
Sep 1, 1984·Biomedizinische Technik. Biomedical Engineering·E Weimer, M Schaldach
Dec 1, 1990·Pacing and Clinical Electrophysiology : PACE·S Furman, Z M Benedek
May 1, 1985·Pacing and Clinical Electrophysiology : PACE·I E KersschotM A Goethals
Aug 1, 1994·Pacing and Clinical Electrophysiology : PACE·B M van GelderM I el Gamal
Sep 1, 1986·Pacing and Clinical Electrophysiology : PACE·G J Van BeekH J Wellens
Mar 1, 1985·Pacing and Clinical Electrophysiology : PACE·D L HayesS A Neubauer
Jul 1, 1987·Pacing and Clinical Electrophysiology : PACE·C C Goren

Related Concepts

Bradycardia
Electric Conductivity
Electrocardiographic Recorders
Implantable Stimulation Electrodes
Heart Block
Artificial Cardiac Pacemaker
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