Case 36-1980: An 82-Year-Old Man with Pacemaker Failure

Presentation of Case An 82-year-old man was admitted to the hospital because of suspected failure of his electronic pacemaker. He was well until five years earlier, when left hemiparesis developed, and he was admitted to the hospital. On the second hospital day cardiac arrest occurred, and he was resuscitated. Persistent ventricular ectopic activity was poorly controlled by multiple medications, and a transvenous electronic pacemaker was inserted, with improvement. A permanent atrial electrode was positioned in the coronary sinus, with a programmable pacemaker set at 90 beats per minute, and the patient was discharged. Digoxin and small doses of quinidine controlled.