Risks of inappropriate use of an algorithm favouring intrinsic conduction

Pacing Clin Electrophysiol. 2022 Dec;45(12):1345-1348. doi: 10.1111/pace.14606. Epub 2022 Oct 27.

Abstract

An 80-year-old woman received a dual chamber pacemaker (Boston Scientific Accolade MRI DR) for pre-syncopal episodes associated with transient II-degree atrioventricular block type 1 and 2:1, recorded in 24-h Holter monitoring. Due to residual AV conduction with I-degree AV block, the pacemaker was set with the RYTHMIQ® algorithm, in order to reduce inappropriate ventricular pacing. A month later the patient started to complain of severe asthenia and bradycardia (46-48 bpm). Telemetry-supported pacemaker control revealed III-degree AV block with junctional escape rhythm, unmasking missed switch of RYTHMIQ® algorithm.

Keywords: RYTHMIQ®; algorithm; pacemaker; ventricular pacing.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Atrioventricular Block* / therapy
  • Humans