A permanent demand pacing generator was impJanted in the right delto‐pectoral fossa with unipolar transvenous lead advanced to the right ventricle. Implant and subsequent pacing parameters were normal. Five days later an emergency DC cardioversion was performed with one paddle 2 inches from the generator. Cardioversion was followed by failure of QRS‐sensing and, at immediate explant, rise in stimulation threshold. The pulse generator showed end‐of‐life characteristics. The patient died 4 days following replacement of the generator and lead. At autopsy, right ventricular infarction was found, presumably relating to currrent discharge along the lead. Pacemaker analysis showed damage to the protection zener diode and oscillator integrated circuit of the generator during cardioversion.
- right ventricular infarction
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine