Deutsche medizinische Wochenschrift (1946) · 2020
[Increased Ventricular Pacing Threshold Caused by Intake of Dronedaron].
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Wedler Katharina, Dávid Árpad, Körber Thomas
Аннотация
HISTORY: The 75 year old patient was hospitalized because of vertigo, exertional dyspnea and clamminess. Based on ischemic heart disease with sick sinus syndrome a pacemaker was implanted 5.5 years ago. In consequence of non-permanent atrial fibrillation Dronedaron was added to medication 8 months ago.
FINDINGS AND DIAGNOSIS: The patient presented unstable. The ECG showed a second-degree atrioventricular block with wenckebach periodic and a frequency of 29 bpm. The pacemaker survey showed primary a proper atrial function but ineffective ventricular stimulation.
THERAPY AND COURSE: After initial external pacing the pacemaker was reprogrammed and in this way the ventricle stimulated effectively. Dronedaron was ceased after checking trigger factors and the patient left hospital after 3 days free of complaints. The pacemaker survey 18 days later showed a proper function with stabilized pacing threshold close to the old level.
CONCLUSIONS: In patients with dysfunction of a permanent pacemaker an increased pacing threshold should be excluded and if any the current medication needs to be controlled. Caution should be exercised to Dronedaron here.
FINDINGS AND DIAGNOSIS: The patient presented unstable. The ECG showed a second-degree atrioventricular block with wenckebach periodic and a frequency of 29 bpm. The pacemaker survey showed primary a proper atrial function but ineffective ventricular stimulation.
THERAPY AND COURSE: After initial external pacing the pacemaker was reprogrammed and in this way the ventricle stimulated effectively. Dronedaron was ceased after checking trigger factors and the patient left hospital after 3 days free of complaints. The pacemaker survey 18 days later showed a proper function with stabilized pacing threshold close to the old level.
CONCLUSIONS: In patients with dysfunction of a permanent pacemaker an increased pacing threshold should be excluded and if any the current medication needs to be controlled. Caution should be exercised to Dronedaron here.