Abstract

CASOLA CRESPO, Roberto; CASOLA CRESPO, Eugenio; CHUNLLO QUISHPI, Rene  and  CASOLA GARCIA, Solanch. Permanent pacemaker: report of a late diagnosis of displacement of the electrode. AMC [online]. 2016, vol.20, n.1, pp. 56-61. ISSN 1025-0255.

Background: in the last years, the placement of permanent pacemakers has become a safe procedure with low rates of complications; however, when these complications present they can cause a fatal end for patients due to the dysfunction of the device. Objective: to analyze the late diagnosis of displacement of the electrode in the permanent pacemaker of a patient. Clinical case: a sixty-six-year-old female patient with a history of high blood pressure of 25 years of evolution. The patient was under a daily treatment with amlodipine and hydrochlorothiazide, 10 and 25 mg respectively. Five years ago, because of third-degree atrioventricular block and syncope, she underwent the implantation of a permanent pacemaker. The patient had a good progress and no complications when discharged from the hospital. Four months after the operation she presented syncope and went to the pacemaker program consultation; there were no problems with the stimulation of the device. She continued presenting dizziness and loss of consciousness so she went to the specialized programmed follow-up consultations. Finally, the patient is diagnosed with displacement of the electrode. She underwent another procedure to place a new lead. She did not present dizziness or syncope in the follow-up. Conclusions: the clinical method is the main element for the diagnosis of complications in the follow-up of patients with permanent pacemakers; still, only one diagnosis element is not enough to discard the problem so is necessary to use other diagnostic means.

Keywords : ELECTRODOS IMPLANTADOS [adverse effects]; BIOLOGICAL CLOCKS; ELECTRODES, IMPLANTED [ADVERSE EFFECTS]; ATRIOVENTRICULAR BLOCK; AGED; CASE STUDIES.

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