Loss of Right Atrial Pacing Lead Capture Due to Myocardial Infarction Obscuring Diagnosis on Electrocardiogram

James A McCaffrey; Bishnu P Dhakal; Ashwin S Nathan; Juan Ortega-Legaspi; Paul N Fiorilli; Paul J Mather; Gregory E Supple

doi:10.1016/j.jaccas.2022.06.001

Loss of Right Atrial Pacing Lead Capture Due to Myocardial Infarction Obscuring Diagnosis on Electrocardiogram

JACC Case Rep. 2022 Jul 20;4(14):890-894. doi: 10.1016/j.jaccas.2022.06.001.

Authors

James A McCaffrey¹, Bishnu P Dhakal¹, Ashwin S Nathan², Juan Ortega-Legaspi³, Paul N Fiorilli², Paul J Mather³, Gregory E Supple¹

Affiliations

¹ Electrophysiology Section, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
² Interventional Cardiology Section, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
³ Advanced Heart Failure Section, Cardiovascular Medicine Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Abstract

Right coronary artery occlusion can lead to failure to capture from the right atrial pacing lead. In this case, acute infarction resulted in failure of the right atrial lead to capture and thus increased right ventricular pacing. The new ventricular pacing masked the diagnosis of acute myocardial infarction. (Level of Difficulty: Intermediate.).

Keywords: MI, myocardial infarction; RA, right atrium; RCA, right coronary artery; RV, right ventricle; cardiac pacemaker; electrocardiogram; myocardial infarction.

Publication types

Case Reports