Complicated Electrocardiographic Presentation Caused by Pacemaker Battery Depletion: A Risk of Spike on T Wave

概要

論文の詳細を見る
A 51-year-old male patient presented to our hospital, complaining of frequent palpitation in 2010. The patient had a history of dual chamber pacemaker implantation due to bradycardia-tachycardia syndrome in 1992. The generator was replaced with the present dual chamber system at other hospital in 1998 because of normal battery decline, however he had lost to follow-up since then. On arrival at the hospital, electrocardiogram revealed that unipolar pulse spikes were confirmed irregularly in sinus rhythm, and some spikes were on the T wave. Pacemaker could not be interrogated due to the severe depletion of battery. Although the patient had stable sinus rhythm and did not depend on pacemaker, he was exposed to risk of ventricular fibrillation resulting from spike on T wave. He was immediately performed pacemaker generator exchange. The both leads were normal. At a later date, pacemaker analysis by the manufacturer revealed sensing failure and power on reset due to lack of voltage supply to the circuit. In conclusion, pacemaker battery depletion has a possibility of critical malfunctions by the voltage drop in the circuit, and may induce spike on T wave leading to fatal arrhythmia. Even if the patient is pacemaker-independent, regular pacemaker clinic is still essential.