Device-related alert message: emergency pacing for bradycardia
Tracing
Manufacturer Biotronik
Device Remote monitoring
Field Messages and events
N° 3
Patient
This 84-year-old man received a Lumax 740 DR-T dual chamber defibrillator for secondary prevention and a history of ischemic cardiomyopathy, 25% left ventricular ejection fraction and episodes of VT causing syncope; the telecardiology function was programmed and the patient returned home.
Graph and trace
Telemedicine report
Within 24 h after his discharge from the hospital, a first alert message was transmitted systematically (yellow color status);
Another alert corresponding to the programming of emergency pacing for bradycardia (red color status) was also transmitted.
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After his discharge from the hospital and activation of telecardiology, the patient powered the transmitter. On the first evening, an event report (yellow color) was received by the centre in charge of the follow-up confirming the proper function of the system. The centre also received a red alert related to the programming of emergency pacing for bradycardia. This function, which causes the programming of emergency VVI pacing at 70 bpm and 7.5 V/1.5 ms (maximum amplitude), can be activated by a switch located on the programmer wand or from the programmer screen. It can be useful in emergency, to immediately restore effective pacing after a programming error (for example a pacing amplitude below threshold) in a pacemaker-dependent patient.
In this case, the last in-hospital programming was performed with wireless telemetry. At the end of programming, the physician did not close the patient’s session and, when putting away the programmer, inadvertently activated the emergency pacing switch. Telemedicine enabled the early diagnosis of this programming error, which, otherwise, would only have been diagnosed at the next face-to-face visit.