The Journal of Thoracic and Cardiovascular Surgery, Vol 69, 365-368, Copyright © 1975 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Runaway pacemaker in seven patients: a persisting problem
A Nasrallah, RJ Hall, E Garcia, ER Kyger, GL Hallman and DA Cooley
Runaway pacemaker has been encountered in 7 patients during the past 7
years at the Texas Heart Institute. In this series, 4 patients with
fixed-rate pacemakers experienced pacemaker arrhythmias because of battery
depletion, and 3 had arrhythmias because of component failure. Battery
deterioration was heralded by an increase in cardiac rate. Ventricular
tachycardia, rapidly followed by ventricular fibrillation, occurred in 2
patients. Prompt surgical exteriorization of the failing pulse generator
and connection to an external pacemaker resulted in prompt recovery in all
patients. Elective generator change should be performed routinely after 24
to 30 months unless reliable serial observations of ventricular rates can
be attained. This at least will reduce the lethal complications attributed
to battery exhaustion. Increasing developments in the design of generators
and sources of power, as well as data from pacemaker clinic follow-up and
telephone pulse transmittal, are expected to decrease the frequency of this
complication.