open access
Deep brain stimulation failure due to external cardioversion in a patient with Parkinson's disease
Affiliations- Neurosurgical Department of Postgraduate Medical Center, Warsaw, Poland
- Neurological Department of Postgraduate Medical Center, Marymoncka 99/103 Street, Warsaw, Poland
open access
Abstract
We report a case of deep brain stimulation (DBS) hardware failure due to emergently performed subcutaneous coronary angioplasties complicated by cardioversion for rapid worsening of angina pectoris and some trouble shooting problems emerged after invasive cardiovascular procedures. The patient with prior implantation of permanent pacemaker due to vasovagal syndrome underwent successful left-sided unilateral electrode implantation into the subthalamic nucleus. During 21 months follow-up period the patient experienced 2 times episodes of aggravation of unstable angina pectoris 15 and 21 months respectively, which necessities emergent coronary angioplasties. After the first emergently performed coronary angioplasty with cardioversion the interrogation of DBS system revealed the depletion of an internal pulse generator (IPG). The secondly performed coronary angioplasty complicated by ventricular tachyarrhythmia with DBS system switched on during emergent cardioversion resulted in partial dysfunction of DBS electrode. Patients harboring cardiovascular implantable electronic devices (CIEDs) and DBS systems require special attention and good cooperation of neurosurgeons, interventional cardiologist, and neurologist. Some emergently performed invasive cardiovascular procedures which necessities cardioversion may cause DBS hardware failure with subsequent worsening of movement disorder symptoms.
Abstract
We report a case of deep brain stimulation (DBS) hardware failure due to emergently performed subcutaneous coronary angioplasties complicated by cardioversion for rapid worsening of angina pectoris and some trouble shooting problems emerged after invasive cardiovascular procedures. The patient with prior implantation of permanent pacemaker due to vasovagal syndrome underwent successful left-sided unilateral electrode implantation into the subthalamic nucleus. During 21 months follow-up period the patient experienced 2 times episodes of aggravation of unstable angina pectoris 15 and 21 months respectively, which necessities emergent coronary angioplasties. After the first emergently performed coronary angioplasty with cardioversion the interrogation of DBS system revealed the depletion of an internal pulse generator (IPG). The secondly performed coronary angioplasty complicated by ventricular tachyarrhythmia with DBS system switched on during emergent cardioversion resulted in partial dysfunction of DBS electrode. Patients harboring cardiovascular implantable electronic devices (CIEDs) and DBS systems require special attention and good cooperation of neurosurgeons, interventional cardiologist, and neurologist. Some emergently performed invasive cardiovascular procedures which necessities cardioversion may cause DBS hardware failure with subsequent worsening of movement disorder symptoms.
Keywords
Deep brain stimulation, Parkinson' s disease, External cardioversion, Cardiovascular implantable electronic devices, Permanent pacemaker
About this articleTitle
Deep brain stimulation failure due to external cardioversion in a patient with Parkinson's disease
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
324-330
Page views
260
Article views/downloads
809
DOI
10.1016/j.pjnns.2017.05.005
Bibliographic record
Neurol Neurochir Pol 2017;51(4):324-330.
Keywords
Deep brain stimulation
Parkinson's disease
External cardioversion
Cardiovascular implantable electronic devices
Permanent pacemaker
Authors
Michał Sobstyl
Małgorzata Michałowska
Urszula Fiszer
Mirosław Ząbek
