Early Detection of Pacing Failure by Home Monitoring: A Case Report of Paroxysmal Atrial Fibrillation

The case is an 87 years old woman. For brady-tachycardia syndrome due to the paroxysmal atrial fibrillation, she was implanted dual-chamber Biotronik pacemaker. She didnot have the problem of the pacemaker one or two months later. She was followed up in Home Monitoring (remote monitoring). We detected the pacing failure of the atrium and ventricle in IEGM, high frequency of ventricular pacing and the increase of premature ventricular contraction (PVC) by Home Monitoring. The cause of pacing failure was a rise in threshold by the cibenzoline. The pacemaker misrecognized the self-QRS to PVC by the crosstalk. As correspondence to each problems, we turned on AV hysteresis, changed the pacing output and the ventricular blanking period after atrium pacing.