open access

Vol 9, No 4 (2014)
Case Reports
Published online: 2014-12-22
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A pseudodysfunction of dual chamber pacemaker — an unusual switch of atrial to ventricular pacing and vice versa observed in Holter monitoring

Krzysztof Kaczmarek, Irmina Urbanek, Jan Ruta, Iwona Cygankiewicz, Paweł Ptaszyński
Folia Cardiologica 2014;9(4):375-377.

open access

Vol 9, No 4 (2014)
Case Reports
Published online: 2014-12-22

Abstract

In patients with cardiac implantable electronic device (CIED), i.e. pacemaker or implantable cardioverter-defibrillator, interpretation of electrocardiographic tracings may be sometimes difficult. We present a 67-year-old male with a dual chamber pacemaker implanted due to the sinus node dysfunction. A 24-hour Holter monitoring revealed an unusual switching from atrial to ventricular pacing and vice versa. The patient was consulted in Invasive Electrocardiology Unit with a diagnosis of pacemaker dysfunction. The simplified electrocardiophysiologic study was performed using pacemaker modalities, which led to understanding the observed phenomena. Often unusual phenomena observed in electrocardiograms imitate dysfunctions of CIED, which may lead to misdiagnosis of a malfunction of the implanted system. However, detailed analysis of the tracings with special attention to mechanisms of device algorithms, led to proper diagnosis. In presented case, a reprogramming of the device appeared to be curative, and further interventions, being pointless, were discarded.

Abstract

In patients with cardiac implantable electronic device (CIED), i.e. pacemaker or implantable cardioverter-defibrillator, interpretation of electrocardiographic tracings may be sometimes difficult. We present a 67-year-old male with a dual chamber pacemaker implanted due to the sinus node dysfunction. A 24-hour Holter monitoring revealed an unusual switching from atrial to ventricular pacing and vice versa. The patient was consulted in Invasive Electrocardiology Unit with a diagnosis of pacemaker dysfunction. The simplified electrocardiophysiologic study was performed using pacemaker modalities, which led to understanding the observed phenomena. Often unusual phenomena observed in electrocardiograms imitate dysfunctions of CIED, which may lead to misdiagnosis of a malfunction of the implanted system. However, detailed analysis of the tracings with special attention to mechanisms of device algorithms, led to proper diagnosis. In presented case, a reprogramming of the device appeared to be curative, and further interventions, being pointless, were discarded.

Get Citation

Keywords

dual-chamber pacemaker, Holter monitoring, dysfunction of CIED, change of pacing mode

About this article
Title

A pseudodysfunction of dual chamber pacemaker — an unusual switch of atrial to ventricular pacing and vice versa observed in Holter monitoring

Journal

Folia Cardiologica

Issue

Vol 9, No 4 (2014)

Pages

375-377

Published online

2014-12-22

Bibliographic record

Folia Cardiologica 2014;9(4):375-377.

Keywords

dual-chamber pacemaker
Holter monitoring
dysfunction of CIED
change of pacing mode

Authors

Krzysztof Kaczmarek
Irmina Urbanek
Jan Ruta
Iwona Cygankiewicz
Paweł Ptaszyński

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