Ventricular pacing redundancy to prevent loss of capture: a fail-safe for pacemaker-dependent patients.

BACKGROUND: Patients who are entirely dependent on ventricular pacing are typically at the mercy of a single ventricular lead and pacemaker output in order to provide physiologic support. This study presents a number of high-risk cases (two of which previously exhibited failure with standard pacing) in which ventricular pacing redundancy (VPR) was utilized in order to provide additional backup. VPR was achieved using a variety of configurations, all of which employed a second ventricular lead and the potential for additional ventricular pacing. Seven cases are presented in which some form of VPR was successfully implemented in order to prevent device failure and resultant hemodynamic collapse.