Rate‐dependent pacing failure after pacemaker implantation: Novel insights into the mechanism of using adenosine. (10th August 2020)

• Record Type: Journal Article
• Authors: Ohe, Hisaharu; Oginosawa, Yasushi; Yamagishi, Yasunobu; Miyamoto, Taro; Tsukahara, Keita; Kohno, Ritsuko; Abe, Haruhiko; Otsuji, Yutaka
• Is Part Of: Journal of cardiovascular electrophysiology. Volume 31:Number 10(2020)
• Page Start: 2765
• Page End: 2769
• Publication Date: 2020-08-10
• Subjects: adenosine triphosphate -- bradycardia‐dependent pacing failure -- pacemaker implantation -- Phase 4 depolarization -- sick sinus syndrome; Blood vessels -- Physiology -- Periodicals; Electrophysiology -- Periodicals; Heart -- Physiology -- Periodicals; 612.1
• DOI: 10.1111/jce.14704
• Languages: English
• ISSNs: 1045-3873

Abstract

Abstract: An 82‐year‐old woman received pacemaker implantation for sick sinus syndrome. Two days after the implantation, electrocardiography showed 2:1 atrial pacing failure, followed by a bradycardia‐dependent increase in the atrial pacing threshold during a pacemaker examination. However, transient 1:1 atrial pacing capture recovered by adenosine triphosphate (ATP) administration, which was performed to evaluate the bradycardia‐dependent pacing failure mechanism. We considered this phenomenon to be caused by Phase 4 depolarization and avoided replacing this atrial lead. Three weeks later, the atrial pacing threshold had improved. We report the potential role of Phase 4 depolarization in a bradycardia‐dependent increase in pacing threshold by using ATP.