Temporary cardiac pacing induced electrocardiographic changes simulating myocardial infarction

Authors

  • Suresh Kumar Behera Department of Cardiology, Institute of Medical Sciences and SUM hospital, Kalinga Nagar, Bhubaneswar-8, Odisha, India
  • Akshaya Kumar Samal Department of Cardiology, Institute of Medical Sciences and SUM hospital, Kalinga Nagar, Bhubaneswar-8, Odisha, India
  • Akshyaya Kumar Pradhan Department of Cardiology, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20174006

Keywords:

ECG changes, Myocardial infarction, Temporary pacing

Abstract

Temporary transvenous pacing is an immediate lifesaving measure in patients with Stokes-Adams syndrome and in patients with symptomatic bradycardia. Bradyarrhythmias are known to occur in acute myocardial infarction. But in a paced heart, it is difficult to diagnose myocardial infarction from electrocardiogram (ECG) because pacemaker rhythm causes distortion of natural wave forms. On the other hand, remarkable T wave inversions and ST depressions do occur in the ventricular paced ECG as secondary changes. The case report describes a patient who developed profound de novo T wave inversions and ST depressions in the unpaced ECG following temporary transvenous pacing simulating MI.

Author Biographies

Suresh Kumar Behera, Department of Cardiology, Institute of Medical Sciences and SUM hospital, Kalinga Nagar, Bhubaneswar-8, Odisha, India

Associate Professor, 

Department of Cardiology, 

Akshaya Kumar Samal, Department of Cardiology, Institute of Medical Sciences and SUM hospital, Kalinga Nagar, Bhubaneswar-8, Odisha, India

Professor & head,
Department of Cardiology,

Akshyaya Kumar Pradhan, Department of Cardiology, King George’s Medical University, Lucknow, Uttar Pradesh, India

Assiatant professor

Department of cardiology 

References

Epstein AE, DiMarco JP, Ellenbogen KA, Estes NM, Freedman RA, Gettes LS, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American college of cardiology/American Heart Association task force on practice guidelines (writing committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmic devices). J Am Coll Cardiol. 2008;51:e1-62.

Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, Breithardt OA, et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eu Heart J. 2013;34:2281-329.

Chatterjee KA, Harris AL, Davies GE, Leatham AU. Electrocardiographic changes subsequent to artificial ventricular depolarization. Br Heart J. 1969;31:770-9.

Gould L, Venkataraman K, Goswami MK, Gomprecht RF. Pacemaker-induced electrocardiographic changes simulating myocardial infarction. Chest. 1973;63(5):829-32.

Rothfeld EL, Zucker DR: Electrical diagnosis of myocardial infarction in the paced dog heart. Ann Intern Med. 1972;76:867.

Ippolito TL, Blier JS, Fox TI. Massive T wave inversion. Am Heart J. 1954;48:88-94.

Burch GE, Meyers R, Abildskov JA. A new electrocardiographic pattern observed in cerebrovascular accidents. Circulation. 1954;9:719-23.

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Published

2017-08-26

How to Cite

Behera, S. K., Samal, A. K., & Pradhan, A. K. (2017). Temporary cardiac pacing induced electrocardiographic changes simulating myocardial infarction. International Journal of Research in Medical Sciences, 5(9), 4172–4174. https://doi.org/10.18203/2320-6012.ijrms20174006

Issue

Section

Case Reports