Tachycardia and Death Due to an Artificial Pacemaker

Abstract

Artificial pace-maker is indicated in: A low idioventricular rhythm rate, open heart surgery for congenital cardiac conditions, surgery on aortic stenosis with auriculoventricular block, and A -V block in acute myocardial infarction. The risks encountered are the development of scar tissue at the point of implantation, misplacement of electrodes on the myocardium, interference of the R wave of the pace-maker with the T wave of the patient''s own rhythm, an incomplete hemodynamic efficiency from a coincidence when the P of the patients rhythm may be placed within the QRS of the pace-maker, local electrolytic disturbance of the myocardial tissue at the place of electrodes, contamination of electrodes, breakage of electrode wire and exhaustion of battery supply. A 50 year old man in whom an artificial pace-maker was implanted because of complete atrioventricular block presented a tachycardia 7 months after operation. The pacemaker''s rhythm rate increased progressively reaching a final rate of 300/1[image]. The failure of the pace-maker occurred in the timing circuit; an increase in the pace-maker''s electromotive force was also observed. Histologically around the insertion of the electrodes, the development of neoplastic connective tissue and formation of granuloma composed of new connective cells was observed; large phagocytes and giant cells of the foreign body type were also present. The patient''s main cardiac disease was arteriosclerotic myocardiopathy.