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A Micro-dislodgement is a minimal displacement in the lead that is not visible in a chest X-ray, but has the ability to increase the capture threshold and eventually cause a loss of capture. [ 5 ] Lead dislodgement can cause sensing failure, which occurs when proper atrial or ventricular sensing is not achieved by the programming of the pacemaker.
[18] [20] Since its first discovery, there have been many definitions of pacemaker syndrome, and the understanding of the cause of pacemaker syndrome is still under investigation. In a general sense, pacemaker syndrome can be defined as the symptoms associated with right ventricular pacing relieved with the return of A-V and V-V synchrony. [17]
Ventricular escape beats occur when the rate of electrical discharge reaching the ventricles (normally initiated by the heart's sinoatrial node (SA node), transmitted to the atrioventricular node (AV node), and then further transmitted to the ventricles) falls below the base rate determined by the rate of Phase 4 spontaneous depolarisation of ventricular pacemaker cells. [1]
This condition can be detected on an electrocardiogram (ECG) as a brief period of irregular length with no electrical activity before either the sinoatrial node resumes normal pacing, or another pacemaker begins pacing. If a pacemaker other than the sinoatrial node is pacing the heart, this condition is known as an escape rhythm.
Since pacemaker correction of the third-degree block requires full-time pacing of the ventricles, a potential side effect is pacemaker syndrome, and may necessitate the use of a biventricular pacemaker, which has an additional 3rd lead placed in a vein in the left ventricle, providing more coordinated pacing of both ventricles. [citation needed]
In general, the treatment of crosstalk includes decreasing atrial pacing output, decreasing atrial pulse width, decreasing ventricular sensitivity, increasing the ventricular blanking period, activating ventricular safety pacing, and new atrial lead implant if insulation failure mandates unipolar programming.
Despite the severe-sounding name, heart block may cause no symptoms at all in some cases, or occasional missed heartbeats in other cases (which can cause light-headedness, syncope (fainting), and palpitations), or may require the implantation of an artificial pacemaker, depending upon exactly where in the heart conduction is being impaired and ...
An ectopic pacemaker located in the atria is known as an atrial pacemaker and can cause the atrial contraction to be faster. [10] An ectopic pacemaker situated near the AV node and the septum is known as a junctional pacemaker. [11] The pacemaker that is operating in the ventricles is known as the ventricular. [12]