Troubleshooting Pacemakers

  • Julia H. Indik
    Requests for reprints should be addressed to Julia H. Indik, MD, PhD, Sarver Heart Center, University of Arizona College of Medicine, 1501 N. Campbell Avenue, Tucson, AZ 85724.
    Sarver Heart Center, University of Arizona, Tucson.
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      Pacemakers are commonly encountered in patients in a routine medicine practice, and the general internist may be the first to encounter a potential malfunction. Our case focuses on a 40-year-old man, who was referred for routine evaluation 6 months after a heart transplant. He had had a history of non-ischemic cardiomyopathy and was maintained on a total artificial heart prior to transplantation. In the immediate postoperative period, he developed symptomatic bradycardia with junctional rhythm. A dual chamber pacemaker was implanted to regulate heart function. He was feeling well and had excellent exercise tolerance following his heart transplantation. He presented for cardiac catheterization for routine surveillance.
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