1, 2 Health-care providers have frequent interactions with patients with pacemakers and implantable cardioverter-defibrillators (ICDs). The number of patients with implantable cardiac devices is continuously increasing. Final version accepted August 13, 2019.Īddress correspondence to: Saima Karim, DO, Department of Cardiology, Metrohealth Medical Center, 2500 Metrohealth Drive, Cleveland, OH 44109-1998, USA. The authors report no conflicts of interest for the published content. Cardiac implantable electronic devices, implantable cardioverter-defibrillator malfunction, loss of capture, noncapture, pacemaker malfunction. A knowledge of these factors is essential for health care providers, given the morbidity and mortality that can potentially be associated with device-related issues, especially in patients who are dependent on the included pacing function. Further, there are also potential noncardiac causes, such as medications, electrolyte imbalance, and acidemia. Loss of capture can also occur from external electrical stimuli and inappropriate pacemaker or ICD settings. This change can be due to a cardiomyopathy, fibrosis medications, metabolic imbalance, lead fracture, or an exit block. In comparison, an increase in the required threshold promoting a loss of capture can happen after months to years of insertion of the pacemaker or ICD. The most common acute cause just after the insertion procedure is lead dislodgement or malposition. There are many causes for a loss of capture, with the timing of the implant having a high correlation with certain causes over others.
Loss of capture can be an emergent presentation for an unstable patient and can be encountered intermittently in hospitalized patients. As more pacemakers and implantable cardioverter-defibrillators (ICDs) are being placed, a basic understanding of some troubleshooting for devices is becoming essential. The number of patients with implantable electronic cardiac devices is continuously increasing. KARIM, MD, 2 AMJAD FARAH, MD, 1 BLAIR GRUBB, MD, 1 and SAIMA KARIM, DO 1,3ġ Division of Electrophysiology, Department of Cardiovascular Medicine, University of Toledo Medical Center, Toledo, OH, USAĢ Deparment of Internal Medicine, Cleveland Clinic, Cleveland, OH, USAģ Department of Cardiology, Metrohealth Medical Center, Cleveland, OH, USAĪBSTRACT. Causes of Failure to Capture in Pacemakers and Implantable Cardioverter-defibrillatorsĮBRAHIM SABBAGH, DO, 1 THAER ABDELFATTAH, MD, 1 MOHAMMAD M.
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