12/9/2023 0 Comments Pacing failure to capture![]() ![]() Variety of clinical symptoms including fatigue, dizziness, palpations, pre-syncope.Caused by improper timing of atrial and ventricular contractions resulting in AV dyssynchrony and loss of atrial “kick”.A chest x-ray will usually help to confirm the diagnosis.If the paced QRS morphology changes from a LBBB pattern (indicating RV placement) to a RBBB pattern (indicating LV placement), this suggests that the electrode has eroded through the interventricular septum.A dislodged pacing lead may float around inside the right ventricle, intermittently “tickling” the myocardium and causing ventricular ectopics or runs of VT (in much the same way as the guide wire of a central line!), alternating with failure of capture.Some great cases of runaway pacemaker are discussed here. ![]()
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