Korean J Med.  2006 Jan;70(1):84-89.

Pacemaker malfunction related to insulation break according to position change in a patient with complete AV block

• Park SW
• Noh HJ
• Nam KS
• Ham SW
• Hong KD
• Lee KD
• Lee HS

Abstract

A 53 year-old woman presented with intermittent dizziness and palpitation. She had received VVI type pacemaker due to complete AV block in 1990, and exchanged by VVIR type pacemaker thirteen years later. 1 year later, she suffered intermittent dizziness and palpitation in erect position, not in supine position. Intermittent pacing failure and sensing failure was observed in pacemaker test, especially in erect position, not in supine position. Pacing threshold was increased in erect position, but lead impedance was not changed. Insulation break was observed in bipolar lead by fluoroscope. Initially we tried a new lead implantation by cephalic access to prevent lead related complication, but failed. So, we implanted a new bipolar lead by subclavian access. Finally, she was treated by a new bipolar lead implantation.

Keyword

Complete AV block; Artificial cardiac pacing; Insulation break

MeSH Terms

Atrioventricular Block*
Cardiac Pacing, Artificial
Dizziness
Electric Impedance
Female
Humans
Middle Aged
Supine Position