Reversible Atrial Lead Dysfunction of DDD Pacemaker After Recent Inferior Myocardial Infarction

Abstract

A patient with DDD pacemaker had pacing dysfunction following an inferior myocardial infarction. The threshold of that implanted right atrial pacing lead was abnormally high but the generator was normal. A temporary lead was inserted into the high right atrium near the appendage and near the low atrium for testing of threshold, which was abnormally high in these 2 places. Forty days after stent implantation in the proximal segment of the right coronary artery, the threshold spontaneously returned to normal. The change threshold of electrode-tissue interface in the right atrium was suspected due to hibernation of right atrium ischemia.