open access

Vol 13, No 4 (2018)
Case Reports
Published online: 2018-09-12
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Should we always trust medical records? Analysis of the case of a patient after cardiac pacemaker implantation with suspected device dysfunction

Anna Kawińska-Hamala, Adam Pagórek, Jerzy Krzysztof Wranicz
DOI: 10.5603/FC.2018.0075
·
Folia Cardiologica 2018;13(4):350-353.

open access

Vol 13, No 4 (2018)
Case Reports
Published online: 2018-09-12

Abstract

The development of technology enables the construction and programming of more advanced devices that stimulate the heart, which is also associated with increased demands on doctors, on the knowledge of pacemakers and interpretation of the electrocardiography ( ECG). The description refers to 77-year-old patient after pacemaker implantation (according to the available documentation - DDDR), due to sick sinus syndrome, admitted to the clinic, because of an episode of fainting and feeling of general weakness, for diagnosis and treatment. ECG recorded an image of atrioventricular block third degree (AVB IIIᵒ), with no data on the presence of ventricular pacing (no ventricular spikes). Preclinical diagnosis was ventricular dysfunction or impaired control in ventricular channel (oversensing in the course of noise?, crosstalk?). ECG with magnet allowed us to exclude ovesrensing. Chest X-ray and programmer control revealed the presence of the one-chamber pacemaker cardiac (AAI). Finally, dual-chamber pacemaker (DDDR), with ventricular electrode was implanted – resulted in obtaining relief of patient symptoms.

Abstract

The development of technology enables the construction and programming of more advanced devices that stimulate the heart, which is also associated with increased demands on doctors, on the knowledge of pacemakers and interpretation of the electrocardiography ( ECG). The description refers to 77-year-old patient after pacemaker implantation (according to the available documentation - DDDR), due to sick sinus syndrome, admitted to the clinic, because of an episode of fainting and feeling of general weakness, for diagnosis and treatment. ECG recorded an image of atrioventricular block third degree (AVB IIIᵒ), with no data on the presence of ventricular pacing (no ventricular spikes). Preclinical diagnosis was ventricular dysfunction or impaired control in ventricular channel (oversensing in the course of noise?, crosstalk?). ECG with magnet allowed us to exclude ovesrensing. Chest X-ray and programmer control revealed the presence of the one-chamber pacemaker cardiac (AAI). Finally, dual-chamber pacemaker (DDDR), with ventricular electrode was implanted – resulted in obtaining relief of patient symptoms.
Get Citation

Keywords

pacemaker; ventricular electrode dysfunction; oversensing

About this article
Title

Should we always trust medical records? Analysis of the case of a patient after cardiac pacemaker implantation with suspected device dysfunction

Journal

Folia Cardiologica

Issue

Vol 13, No 4 (2018)

Pages

350-353

Published online

2018-09-12

DOI

10.5603/FC.2018.0075

Bibliographic record

Folia Cardiologica 2018;13(4):350-353.

Keywords

pacemaker
ventricular electrode dysfunction
oversensing

Authors

Anna Kawińska-Hamala
Adam Pagórek
Jerzy Krzysztof Wranicz

References (9)
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