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Europace Advance Access originally published online on March 23, 2006
Europace 2006 8(5):385-387; doi:10.1093/europace/eul013
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


PACING

Ventricular capture by anodal pacemaker stimulation

Eraldo Occhetta*, Miriam Bortnik and Paolo Marino

Divisione Clinicizzata di Cardiologia, Facoltà di Medicina e Chirurgia di Novara, Università degli Studi del Piemonte Orientale, Azienda Ospedaliera Maggiore della Carità, Corso Mazzini 18, 28100 Novara, Italy

This report describes the case of an 86-year-old male with syncopal paroxysmal 2:1 atrioventricular block and a single chamber VVI pacemaker programmed to bipolar sensing and unipolar pacing. After recurrence of syncope, a complete loss of ventricular capture with regular ventricular sensing was observed on ECG; fluoroscopic examination suggested perforation of the right ventricle by the helix of the implanted screw-in lead. Reprogramming the pacemaker to bipolar pacing/sensing resulted in regular ventricular capture and sensing, suggesting effective anodal stimulation from the ring electrode permitting complete non-invasive palliation.

Key Words: Anodal stimulation, Cardiac pacing, Atrioventricular block


* Corresponding author. Tel: +39 (0) 321 3733413; fax: +39 (0) 321 3733407. E-mail address: occhetta{at}r-j.it/eraldo.occhetta{at}maggioreosp.novara.it


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