 |
| Click to enlarge |
Rate:
- Atrial rate 79 bpm
- Pacemaker rate 79 bpm
- Ventricular rate 12 bpm
- Regular atrial activity
- Pacing spike following every PPM
- Only 2 episodes of ventricular capture
- Likely LAD
- QRS - Prolonged
- Abnormal QRS morphology in leads V1-3 not typical LBBB
- Loss of ventricular capture
Causes of pacemaker failures
In broad terms there is either a problem with the pacemaker signal generator, the connection to the patient or the patient. These can be further expanded:
- Signal generator problems
- End-of-life
- Battery failure
- Programming issue
- Over or under sensing
- Connection between unit and patient
- Lead fracture
- Lead malposition
- Lead migration
- Lead fibrosis
- Patient factors
- Progression of underlying disease
- Ischaemia
- Electrolyte / acid-base disturbance
- Drug toxicity
The patient was stabilised with a combination of transcutaneous pacing and isoprenaline infusion. Pacemaker interrogation revealed increased impedance in the RV lead and increasing the voltage resulted in ventricular capture, this was likely due to early lead failure and the patient was transferred for PPM replacement.
References / Further Reading
Life in the Fast Lane
Textbook
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
PPCexpo has introduced a horizontal gray bar to measure the data from the previous period on a Pareto chart. This allows you to compare data from the most recent period with data from the previous period, which helps to investigate the status of significant contributions in the previous period.
ReplyDeletehttps://ppcexpo.com/blog/how-to-read-pareto-chart
Hi, blogger finally I found this quality, informative content. thanks for sharing this knowledgeable content.
ReplyDeleteThe Texas CRM software assesses and matches every type of business need and process. SalezShark experts always embrace a "company prior" strategy to develop a perfect CRM to operate out of fundamental to hard company's operations in a well-organized method.