Iatrogenic Epicardial Pacing-Induced Arrhythmias After Cardiac Surgery.
Russell A Caratenuto, Joshua M Cooper, Suyog A Mokashi et al.
✦ AI-curated · Sources linked
Case in brief
Three patients who underwent cardiac surgery and had temporary epicardial pacing wires developed polymorphic ventricular tachycardia. In each case, the arrhythmia was linked to pacing-wire undersensing caused by inappropriate device settings. Recognizing the programming problem led to changes in the temporary pacer settings and corrected management, avoiding unnecessary procedural interventions.
What made this case unusual
The arrhythmias arose from epicardial pacing-wire undersensing due to inappropriate programming, a potentially overlooked device-related cause that prompted consideration of unnecessary procedures.
Diagnostic / clinical pearl
In a post-cardiac-surgery patient with polymorphic ventricular tachycardia and temporary epicardial pacing, assess for undersensing and review the pacer settings before pursuing procedural interventions.
Why it matters
Confusing, counterintuitive terminology for temporary epicardial pacing parameters may contribute to missed opportunities to identify a preventable safety hazard.