Diaphragmatic pacemaker-induced ventricular tachycardia leading to cardiac arrest: a case report. Issue 9 (7th September 2021)

• Record Type: Journal Article
• Authors: Dong, Tony; Chami, Tarek; Janus, Scott; Hajjari, Jamal; Fernandez, Antonio Sotolongo; Josephson, Richard
• Editors: Ang, Richard; Sinning, Christoph; Niederseer, David; Mukherjee, Rahul; Ranganathan, Deepti
• Is Part Of: European heart journal. Volume 5:Issue 9(2021)
• Publication Date: 2021-09-07
• Subjects: Diaphragmatic pacemaker -- Ventricular tachycardia -- Cardiac arrest -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab352
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Diaphragmatic pacemakers are used to assist respiration in ventilator-dependent patients. Electromagnetic interference with intrinsic cardiac electrical activity is a theoretical risk but has never been reported in the literature. This case highlights a serious complication of cardiac arrest as a result of diaphragmatic pacing. Case summary: We report a quadriplegic patient with recent diaphragmatic pacemaker implantation who presented with ventricular tachycardia leading to cardiac arrest. Extensive workup was negative for other aetiologies for ventricular arrhythmias. Reduction of the left-sided diaphragmatic pacemaker voltage resulted in cessation of ventricular ectopy. Discussion: Diaphragmatic pacing at high voltages can cause unwanted transmission of impulses to the cardiac myocytes as a rare complication. This should be noted as a possible complication of intramuscular diaphragmatic pacing, and efforts should be taken to circumvent this risk in the future.