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Rate-dependent pacing failure after pacemaker implantation:Novel insights into the mechanism of using adenosine
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  • Hisaharu Ohe,
  • Yasushi Oginosawa,
  • Taro Miyamoto,
  • Yamagishi Yasunobu,
  • Keita Tsukahara,
  • Ritsuko Kohno,
  • Haruhiko Abe,
  • Yutaka Otsuji
Hisaharu Ohe
University of Occupational and Environmental Health Japan
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Yasushi Oginosawa
Sangyo Ika Daigaku
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Taro Miyamoto
University of Occupational and Environmental Health Japan
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Yamagishi Yasunobu
University of Occupational and Environmental Health Hospital
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Keita Tsukahara
University of Occupational and Environmental Health Japan
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Ritsuko Kohno
University of Occupational and Environmental Health, Kitakyushu, Japan
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Haruhiko Abe
University of Occupational and Environmental Health, Japan
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Yutaka Otsuji
University of Occupational and Environmental Health, Japan,
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Abstract

An 82-year-old woman received pacemaker implantation for sick sinus syndrome. Two days after the implantation, electrocardiography showed 2:1 atrial pacing failure, followed by bradycardia-dependent increase in the atrial pacing threshold during a pacemaker examination. However, transient 1:1 atrial pacing capture recovered by adenosine triphosphate (ATP) administration, which was performed to evaluate the bradycardia-dependent pacing failure mechanism. We considered this phenomenon to be caused by phase 4 depolarization and avoided replacing this atrial lead. Three weeks later, the atrial pacing threshold had improved. We report the potential role of phase 4 depolarization in bradycardia-dependent increase in pacing threshold by using ATP.

Peer review status:ACCEPTED

22 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
23 Jun 2020Submission Checks Completed
23 Jun 2020Assigned to Editor
24 Jun 2020Reviewer(s) Assigned
11 Jul 2020Review(s) Completed, Editorial Evaluation Pending
13 Jul 2020Editorial Decision: Revise Minor
20 Jul 20201st Revision Received
22 Jul 2020Submission Checks Completed
22 Jul 2020Assigned to Editor
22 Jul 2020Reviewer(s) Assigned
23 Jul 2020Review(s) Completed, Editorial Evaluation Pending
27 Jul 2020Editorial Decision: Accept