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(Chest. 1974;65:227-229.)
© 1974 American College of Chest Physicians

Runaway Pacemaker with Demonstration of Supernormal Period of Excitation

Udipi R. Shettigar M.D.1; Robert E. Kleiger M.D.1; Ronald Krone M.D.1; and Alexander S. Geha M.D., F.C.C.P.1

1 Division of Cardiology, Department of Medicine, The Jewish Hospital of St. Louis, Washington University School of Medicine, St. Louis

This report documents the presence of supernormal conduction in the normal heart. A 26-year-old woman with congenital heart block treated with a fixed-rate permanent pacemaker returned to the hospital with evidence of pacemaker failure. Pacemaker spikes occurred regularly at a rate of 140 per minute, eliciting ventricular responses only when they occurred during the supernormal period of the cardiac cycle. Telemetric cardiac monitoring revealed complete pacemaker capture, at a rate of 140 per minute when the patient was walking. Following replacement of the pulse generator, the pacemaker performed effectively.






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Copyright © 1974 by the American College of Chest Physicians.