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Europace 2002 4(4):427-430; doi:10.1053/eupc.2002.0263
© 2002 by European Society of Cardiology
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CASE REPORT

Inappropriate high-rate ventricular pacing in a patient with a defibrillator

S. Zaim1, H. Sunthorn1, J.-J. Adatte1, K. Kürsteiner1, D. Burgener2 and C. Huehn2

1Division of Cardiology, University Hospital of Geneva Geneva, Switzerland; 2Department of Medicine, University Hospital of Geneva Geneva, Switzerland

We describe a patient who presented with high rate ventricular pacing secondary to dysfunction of his implantable cardioverter defibrillator (ICD). The device was also unable to communicate with the programmer and unable to treat ventricular fibrillation. Immediate disconnection of the ICD from the leads was the only effective recourse. Subsequent detailed technical analysis of the device revealed a different electrical circuit problem from that found in typical cases of runaway pacing. To our knowledge this is the first description of a malfunction of precisely this nature.

Key Words: High rate pacing, runaway pacemaker, ICD, malfunction

Correspondence: Sina Zaim, MD, Division of Cardiology, New Jersey Medical School, 185 S. Orange Avenue, Newark, NJ, 07103-2714, USA. Tel: (001) 973-972-1969; fax: (001) 973-972-1969; email: szaimmd{at}hotmail.com

[1] Wallace WA, Abelmann WH, Norman JC. Runaway demand pacemaker. Report, in vitro reproduction and review. Ann Thorac Surg 1970; 9: 209–220.[Medline]

[2] Bramowitz AD, Smith JW, Eber LM, Berens SC, Bilitch M, Grechko M. Runaway pacemaker: A persisting problem. JAMA 1974; 228: 340–341.[Abstract/Free Full Text]

[3] Mickley H, Andersen C, Hedemann Nielsen L. Runaway pacemaker: A still existing complication and therapeutic guidelines. Clin Cardiol 1989; 12: 412–414.[Medline]

[4] Griffin J, Smithline H, Cook J. Runaway pacemaker: A case report and review. J of Emergency Medicine 2000; 19: 177–181.[CrossRef]

[5] Carpenter CM, Galvin JG, Guy M, McGovern BA. Runaway pacemaker in an implantable cardioverter defibrillator. J Cardiovasc Electrophysiol 1998; 9: 1008–1011.[CrossRef][Web of Science][Medline]

[6] Blitzer ML, Marieb MA, Schoenfeld MH. Inability to communicate with ICDs: An underreported failure mode. Pacing Clin Electrophysiol 2001; 24: 13–15.[CrossRef][Medline]

[7] Hauser RG, Hayes DL, Almquist AK, et al. Unexpected ICD pulse generator failure due to electronic circuit damage caused by electrical overstress. Pacing Clin Electrophysiol 2001; 24: 1046–1054.[CrossRef][Medline]


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This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
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Right arrow Articles by Zaim, S.
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PubMed
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Right arrow Articles by Huehn, C.
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