Atrial Undersensing-Associated Premature Atrial Contractions: A Case Report

Sažetak


Atrial undersensing is defined as the inability of the pacemaker to detect spontaneous atrial activity. A case of premature atrial contractions associated with atrial undersensing is presented. A 33-year-old woman presented with irregular heartbeat and general weakness. A single atrial stimulation (AAI) pacemaker was implanted seven years earlier for recurrent syncope associated with sinus arrest. Ambulatory ECG monitoring revealed multiple episodes of atrial undersensing resulting in premature atrial contractions (PACs). Occasionally, blocked PACs or PACs with aberrancy associated with atrial undersensing were seen. After improvement of atrial sensing, no episodes of undersensing were found and the complaints disappeared.

Reference

Safavi-Naeini P, Saeed M. Pacemaker troubleshooting: common clinical scenarios. Tex Heart Inst J. 2016 Oct 1;43(5):415-8. doi: 10.14503/THIJ-16-5918.

Antonioli GE, Ansani L, Barbieri D, Guardigli G, Percoco GF, Toselli T. Italian multicenter study on a single lead VDD pacing system using a narrow atrial dipole spacing. Pacing Clin Electrophysiol. 1992 Nov;15(11 Pt 2):1890-3. doi: 10.1111/j.1540-8159.1992.tb02988.x.

Wiegand UK, Bode F, Schneider R, Brandes A, Haase H, Katus HA, et al. Diagnosis of atrial undersensing in dual chamber pacemakers: impact of autodiagnostic features. Pacing Clin Electrophysiol. 1999 Jun;22(6 Pt 1):894-902. doi: 10.1111/j.1540-8159.1999.tb06813.x.

Van Campen CM, De Cock CC, Huijgens J, Visser CA. Clinical relevance of loss of atrial sensing in patients with single lead VDD pacemakers. Pacing Clin Electrophysiol. 2001 May;24(5):806-9. doi: 10.1046/j.1460-9592.2001.00806.x.

Palanca V, Navarro A, Jiménez J, Quesada A, Morell S, Roda J. Intermittent atrial undersensing in single-lead VDD pacemakers in patients with bradycardia-sensitive repolarisation: a possible mechanism for ventricular arrhythmia. Rev Esp Cardiol. 2010 Feb 1;63(2):229–32. doi: 10.1016/S1885-5857(10)70042-6.

Glikson M, Nielsen JC, Kronborg MB, Michowitz Y, Auticcho A, Barbash IM, et al. 2021 ESC Guidelines on cardiac pacing and cardiac resynchronisation therapy: Developed by the Task Force on cardiac pacing and cardiac resynchronisation therapy of the European Society of Cardiology (ESC) With the special contribution of the European Heart Rhythm Association (EHRA). Eur Heart J. 2021; 42(35):3427–520. doi:10.1093/eurheartj/ehab364.

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2024/08/22
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