Clinical interactions between pacemakers and automatic implantable cardioverter-defibrillators

Hugh Calkins, Jeffrey Brinker, Enrico P. Veltri, Thomas Guarnieri, Joseph H. Levine

Research output: Contribution to journalArticlepeer-review

94 Scopus citations


Concomitant use of a pacemaker and an automatic implantable cardioverter-defibrillator (AICD) is common. Seventeen percent of patients receiving an AICD at The Johns Hopkins Hospital also had a permanent pacemaker implanted before (16 patients), at the same time as (2 patients) or after (12 patients) AICD implantation. Four types of interactions were noted: 1) transient failure to sense or capture immediately after AICD discharge (seven patients); 2) oversensing of the pacemaker stimulus by the AICD, leading to double counting (one patient); 3) AICD failure to sense ventricular fibrillation resulting from pacemaker stimulus oversensing (three patients, one only at high asynchronous output); and 4) pacemaker reprogramming caused by AICD discharge (three patients). No clinical sequelae of these interactions were noted during follow-up study. Thus, potentially adverse clinical interactions are common and routine screening is recommended. With proper attention to lead placements and programming of the devices, clinical consequences of these interactions can be avoided.

Original languageEnglish (US)
Pages (from-to)666-673
Number of pages8
JournalJournal of the American College of Cardiology
Issue number3
StatePublished - Sep 1990

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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