A Case of Cross Stimulation

Abstract

Cross stimulation in a dual chamber pacing system, in which the atrial stimulus intermittently captured the right ventricle, occurred immediately after pacemaker implantation in a 71-year-old man. It was prevented temporarily by reducing the pacing rate so that P wave synchronous ventricular (VDD) pacing resulted and by reducing the output of the atrial circuit from 5 to 4 volts. Cross stimulation disappeared spontaneously 14 days after surgery.

Case of Dual Chamber Pacemaker with Cross Stimulation

“…For all these situations, surgical revision of pacing system is the only option for correction. Several reports of cross stimulation have been reported, but they are not due to these situations [1][2][3]. The internal crossover within the pulse generator may be the cause.…”

Pseudo‐Cross‐Stimulation due to First Degree AV Block

“…This was first described by Levine et al 1 in 1985 and was attributed to several different causes. Subsequent reports 2–8 of this phenomenon have ascribed this to be due to either the proximity of the atrial lead to the ventricular chamber, or to the intrinsic design features of certain pacemakers and analyzers. Common to all cases has been the need for a very low ventricular capture threshold that allows pacing of the ventricle by output stimuli of relatively small amplitude.…”

Cross‐Stimulation During Lead Impedance Monitoring

“…It has been reported in some of the early DDD devices, where internal connections between atrial and ventricular channels were responsible for the phenomenon. 1,6,7 Cross-stimulation was often observed shortly after implantation and resolved with growing electrode maturation. Levine et al 2 also reported design re-lated cross-talk during magnet application in an early Intermedics Cosmos (model 283-01) pulse generator.…”