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Europace Advance Access published online on March 23, 2006
Europace, doi:10.1093/europace/eul013
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© The European Society of Cardiology 2006. All rights reserved
Received November 1, 2005
Accepted February 10, 2006

Article

Ventricular capture by anodal pacemaker stimulation

Eraldo Occhetta 1 *, Miriam Bortnik 1, and Paolo Marino 1

1 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

* To whom correspondence should be addressed.
Eraldo Occhetta, E-mail: occhetta{at}r-j.it/eraldo.occhetta@maggioreosp.novara.it


  Abstract

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.

Keywords: Anodal stimulation; Cardiac pacing; Atrioventricular block.
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