T HIS 56-YEAR-OLD MAN WAS ADMITTED to Hahnemann Hospital because of frequent Adams-Stokes attacks. He had experienced an acute myocardial infarction in 1958 and again in 1961. Frequent convulsions occurred in spite of administration of atropine, isoproterenol, and chlorothiazide. On January 3, 1962, an electric pacemaker was implanted on the left ventricle. The following electrocardiographic st...

Single fibre EMG was used to record bizarre repetitive discharges in patients with chronic denervation or muscle disorders. The low variability of intervals between individual spike components on successive discharges suggests that the bizarre repetitive discharges are based on ephaptic impulse transmission from the muscle fibre starting the discharge (principal pacemaker) to the adjacent muscl...

our understanding of the patterns of ectopic activity that might arise as a consequence of the interaction of two pacemakers across a zone of block. Superfusion of the central segment of a dog Purkinje fiber with an ion-free isotonic sucrose solution provided a narrow region of block. The modulation of pacemaker activity by electrotonic potentials transmitted across the area of block was shown ...

The purpose of this report is to describe the more common problems encountered with permanent pacemakers and their management. One of the serious recurring problems is loss of output from the pacemaker. As a result, no pacemaker impulse whatsoever is seen on the electrocardiogram and the heart rate appears slower than the fixed rate of the pacemaker. In such a situation, if a patient is pacemak...

OBJECTIVES This study was done to evaluate pacemaker therapy for severe recurrent vasovagal syncope. BACKGROUND Nonrandomized studies have suggested that permanent pacing might help control the symptoms of recurrent vasovagal syncope. The study goal was to evaluate the effect of permanent pacemaker implantation on syncope in patients with frequently recurrent vasovagal syncope. METHODS Pati...

Intracardiac thrombosis is an infrequent and fatal complication in patients with an inserted pacemaker. A patient with an inserted pacemaker scheduled for ureter stone removal experienced cardiac arrest and cardiopulmonary resuscitation under general anesthesia. Echocardiography showed multiple intracardiac thrombi. Preoperative diagnostic workup including echocardiography for the detection of ...

Several patients receive a permanent pacemaker in a relatively young age, with multiple subsequent reoperations for pacemaker replacement. Pulse generator replacement is an invasive procedure, associated with the risk of various complications, mainly infection and skin erosion. A case of an extremely long-lasting pacemaker with a totally uneventful longevity period over 31 years is presented. T...

Of pacemaker malfunctions,1 runaway pacemaker events are infrequent electronic complications that present at any time in the life of the pacemaker.2-4 Described between 2 days and 9 years after implantation, they are life-threatening emergencies that can go undetected if they appear intermittently.5,6 Recently, we attended a 96 year-old woman with a VVIR Medtronic Minix-ST pacemaker implanted i...

160 Twiddler's syndrome was first described by Bayliss et al. in 1968 [1]. This condition is a rare cause of pacemaker failure, resulting from the dislodging of pacing electrodes by manipulation, often unconsciously, of the implanted pacemaker [2]. This report describes a rare condition of pacemaker failure in a patient with twiddler's syndrome resulting from unintentional rotation of the pacem...

With the widespread application of permanent cardiac pacing, many publications have described bizarre manifestations of pacemaker failure including cases of life-threatening tachyarrhythmias induced by the pacemaker (Costeas et al., I965; Robinson et al., I965; Wisoff, Gabor, and Donoso, I965; Wallace, Abelmann, and Norman, 1970; Barold, I973). The purpose of this communication is to report the...