Runaway pacemaker: a forgotten phenomenon?

Daniel F Ortega, M Victoria Sammartino, Graciela M M Pellegrino, Luis D Barja, Gaston Albina, Eliseo V Segura, Roberto Balado, Ruben Laiño, Alberto G Giniger
Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology 2005, 7 (6): 592-7
Runaway is an uncommon pacemaker dysfunction, characterized by fast and erratic spikes at non-physiological rates. This infrequent but potentially lethal failure mode may be related to low battery voltage. Four single chamber pacemaker patients were analyzed (Medtronic Minix ST 8330, Minneapolis, MN, had been implanted in two patients and two CPI Triumph VR 1124, St Paul, MN, in the other two). They had been admitted because of presyncopal episodes. Typical high rate stimuli at 2000 ppm alternating with pacing at 60-65 ppm were recorded in all ECGs. Lead system tests were normal. The pulse generators had to be replaced.

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