{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:33Z","timestamp":1753876233841,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T00:00:00Z","timestamp":1616198400000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Modern permanent pacemakers (PPMs) have individual features designed to identify cardiac rhythm abnormalities and improve their performance. Inappropriate pacing inhibition may be an undesired outcome from these features and cause symptoms in patients who require frequent pacing, leading to dizziness, and syncope. Inappropriate inhibition can be difficult to identify in circumstances that are intermittent and difficult to reproduce.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 57-year-old female underwent a mitral valve replacement (MVR) for severe mitral stenosis. One month following MVR, she presented with symptomatic third-degree atrioventricular block, and a dual-chamber PPM (Advisa\u2122, Medtronic, Minneapolis, USA) was implanted and programmed DDD 50\u2013130 b.p.m. At the 3-month follow-up, she reported frequent episodes of lightheadedness. She was found to have intermittent ventricular pacing inhibition on a 48-h Holter monitor due to an internal function of the Advisa\u2122 series of PPMs that attempts to store an electrogram (EGM) every 1\u2009h and 30\u2009s. During the EGM storage, an amplified signal from the storage capacitor can result in oversensing by the ventricular channel and inappropriate pacing inhibition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>To rectify the issue, the ventricular lead sensitivity value was increased from 0.9\u2009mV to 1.2\u2009mV. No instances of inappropriate ventricular pacing inhibition were noted on follow-up. To our knowledge, this is a rare case of inappropriate ventricular pacing inhibition caused by a combination of PPM self-adjusting sensitivity algorithm and oversensing every 1\u2009h and 30\u2009s from an amplified storage capacitor. Physicians should be aware of this possible complication and differentiate it from device or lead malfunction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab096","type":"journal-article","created":{"date-parts":[[2021,3,20]],"date-time":"2021-03-20T06:15:39Z","timestamp":1616220939000},"source":"Crossref","is-referenced-by-count":2,"title":["A case report of inappropriate inhibition of ventricular pacing due to a unique pacemaker electrogram storage feature"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4828-5768","authenticated-orcid":false,"given":"Habib R","family":"Khan","sequence":"first","affiliation":[{"name":"London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6748-0713","authenticated-orcid":false,"given":"William K","family":"Chan","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7548-8712","authenticated-orcid":false,"given":"Juliana","family":"Kanawati","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8435-6511","authenticated-orcid":false,"given":"Raymond","family":"Yee","sequence":"additional","affiliation":[{"name":"London Health Sciences Centre, University of Western Ontario, 339 Windermere Road, London, ON N6A 5A5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,20]]},"reference":[{"key":"2021071002562328600_ytab096-B1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/j.1540-8167.2008.01396.x","article-title":"Pacing features that mimic malfunction: A review of current programmable and automated device functions that cause confusion in the clinical setting","volume":"20","author":"Lloyd","year":"2009","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021071002562328600_ytab096-B2","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1111\/jce.14276","article-title":"A review of specialized and automated features in implantable cardiac devices","volume":"31","author":"Ayinde","year":"2020","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021071002562328600_ytab096-B3","first-page":"e333","article-title":"2018 ACC\/AHA\/HRS Guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay: executive summary: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society","volume":"140","author":"Kusumoto","year":"2019","journal-title":"Circulation"},{"key":"2021071002562328600_ytab096-B4","doi-asserted-by":"crossref","first-page":"2281","DOI":"10.1093\/eurheartj\/eht150","article-title":"2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). 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