Late presentation of recurrent syncope after permanent pacemaker implantation due to Lead-Header malapposition

Steven Mazzone; Utkarsh Kohli; Zaid A Aziz; Andrew D Beaser; Gaurav A Upadhyay; Roderick Tung; Hemal M Nayak

doi:10.1016/j.ipej.2020.11.019

Late presentation of recurrent syncope after permanent pacemaker implantation due to Lead-Header malapposition

Indian Pacing Electrophysiol J. 2021 Mar-Apr;21(2):124-127. doi: 10.1016/j.ipej.2020.11.019. Epub 2020 Nov 30.

Authors

Steven Mazzone¹, Utkarsh Kohli², Zaid A Aziz¹, Andrew D Beaser¹, Gaurav A Upadhyay¹, Roderick Tung¹, Hemal M Nayak¹

Affiliations

¹ The University of Chicago Pritzker School of Medicine, Center for Arrhythmia Care, Heart and Vascular Center, Chicago, IL, USA.
² Section of Pediatric Cardiology, Department of Pediatrics, Comer Children's Hospital and the University of Chicago Pritzker School of Medicine, Chicago, IL, USA. Electronic address: ukohli@peds.bsd.uchicago.edu.

Abstract

Permanent pacemaker (PPM) malfunction due to electrical connection problems such as a loose set screw or lead-header malapposition is extremely rare. We present a patient with complete heart block (CHB) who had PPM malfunction and recurrent syncope, late (14 months) after initial implantation, which was caused by the ventricular lead pin disengagement from the header resulting in oversensing due to noise, pacing inhibition and recurrent syncope. PPM due to lead-header malapposition this late after device implantation has previously not been reported.

Keywords: Lead-header malapposition; Oversensing; Pacemaker malfunction; Recurrent syncope.

Publication types

Case Reports