Risks of inappropriate use of an algorithm favouring intrinsic conduction. Issue 12 (27th October 2022)

• Record Type: Journal Article
• Authors: Lo Savio, Armando; Crea, Bruna; Dattilo, Giuseppe; Crea, Pasquale
• Is Part Of: Pacing and clinical electrophysiology. Volume 45:Issue 12(2022)
• Page Start: 1345
• Page End: 1348
• Publication Date: 2022-10-27
• Subjects: algorithm -- pacemaker -- RYTHMIQ® -- ventricular pacing; Cardiac pacing -- Periodicals; Electrophysiology -- Periodicals; 617.4120645
• DOI: 10.1111/pace.14606
• Languages: English
• ISSNs: 0147-8389

Abstract

Abstract: An 80‐year‐old woman received a dual chamber pacemaker (Boston Scientific Accolade MRI DR) for pre‐syncopal episodes associated with transient II‐degree atrioventricular block type 1 and 2:1, recorded in 24‐h Holter monitoring. Due to residual AV conduction with I‐degree AV block, the pacemaker was set with the RYTHMIQ® algorithm, in order to reduce inappropriate ventricular pacing. A month later the patient started to complain of severe asthenia and bradycardia (46‐48 bpm). Telemetry‐supported pacemaker control revealed III‐degree AV block with junctional escape rhythm, unmasking missed switch of RYTHMIQ® algorithm.