Inappropriate mode switching clarified by using a chest radiograph. Issue 4 (14th February 2015)

• Record Type: Journal Article
• Authors: Marino, Brian; Jaiswal, Abhishek; Goldbarg, Seth
• Is Part Of: Journal of arrhythmia. Volume 31:Issue 4(2015)
• Page Start: 246
• Page End: 248
• Publication Date: 2015-02-14
• Subjects: Inappropriate mode switching -- Electrogram -- pacemaker artifact -- Oversensing -- Pseudoatrial tachyarrhythmia; Arrhythmia -- Periodicals; Cardiac pacing -- Periodicals; Arrhythmias, Cardiac; Arrhythmia; Cardiac pacing; Periodicals; Electronic journals; Periodicals; 616.128
• DOI: 10.1016/j.joa.2015.01.001
• Languages: English
• ISSNs: 1880-4276

Abstract

Abstract: An 80‐year‐old woman with a history of paroxysmal atrial fibrillation and atrioventricular node disease status post‐dual chamber pacemaker placement was noted to have abnormal pacing episodes during a percutaneous coronary intervention. Pacemaker interrogation revealed a high number of short duration mode switching episodes. Representative electrograms demonstrated high frequency nonphysiologic recordings predominantly in the atrial lead. Intrinsic pacemaker malfunction was excluded. A chest radiograph showed excess atrial and ventricular lead slack in the right ventricular inflow. It was suspected that lead–lead interaction resulted in artifacts and oversensing, causing frequent short episodes of inappropriate mode switching.