Therapeutic Research

Abstract

Eighty years old female who was diagnosed as an advanced atrioventricular conduction block implanted the implantable pacing generator. Although, the atrial pacing lead was screwed in a right atrial appendage, sensing value of atrium was unstable by the lead shape in the right atrium. The pacing system analyzer revealed as pacing threshold 1.5 V / 0.4 ms, 2.5 mV of atrial sensing, and 792Ω of lead impedance at end of the implantation. After two days, the slight towed of the atrial lead was confirmed by chest X–ray, and the fluctuation of an atrial sensing which was 1.0 mV at sitting position, and 6.0 mV at the spine position was observed. She was discharged because of no change of the pacing threshold and pacing lead impedance and the remote monitoring system was introduced to follow up the data of the pacing generator. Seven days after discharge, the atrial pacing threshold increased over 2.5 V which found by the remote monitoring system. The fluoroscopy showed that the atrial pacing lead was dropped in the right atrium, and we performed re –implantation. The remote monitoring system was useful to detect abnormalities of pacing system earlier.