Supraventricular tachycardia induced by Datex patient monitoring system

Monitor-induced tachycardia in a patient with a rate-responsive pacemaker

A patient with a ventricle-paced, ventricle-sensed and inhibited, respiratory rate-responsive pacemaker presented for orthopaedic surgery. She had been operated upon recently without any adverse effects. In the recovery unit her electrocardiograph showed a paced ventricular tachycardia of about 140 beats x min(-1) without any other adverse sign or symptom. Although this tachycardia initially decreased to 70 beats x min(-1) after about 30 min, it later rose again to 140 beats x min(-1). A pacemaker technician was consulted, who suggested that there may be interference between the bioelectric impedance signals of the patient monitoring system that was being used to measure respiratory rate and the pacemaker's own measurement systems.

Pacemaker Tachycardia in a Minute Ventilation Rate-Adaptive Pacemaker Induced by Electrocardiographic Monitoring

Programmed upper rate pacing occurred in a patient with a rate-adaptive pacemaker when he was connected to a cardiac monitor in an emergency department. The tachycardia was mistakenly interpreted to be ventricular tachycardia and the patient received multiple DC shocks as well as intravenous amiodarone and sotalol, resulting in severe hemodynamic deterioration. It is important that physicians working in the hospital environment be familiar with this pacemaker-monitor interaction as the problem may be easily rectified by disconnecting the monitor or by reprogramming the pacemaker to a nonrate-adaptive pacing mode.