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Summary

Key Learning Points

1. Knowledge of both permanent and temporary pacing systems is necessary, as both are encountered in the intensive care environment.
2. A chest X-ray will provide all the information required to identify the type of permanent device in situ.
3. All implantable cardioverter–defibrillators (ICDs) have full pacemaker capabilities.
4. Magnets will turn off all anti-tachycardia therapies from an ICD, but not anti-bradycardia therapies.
5. External defibrillator pads must be applied if ICD therapies are turned off.

This case illustrates acute myocarditis with complete heart block in a 13-year-old teenager as a rare complication of acute dengue illness. He required urgent temporary pacing with inotropic support and antifailure medications. Complete heart block in dengue myocarditis is an acute but reversible condition. A similar presentation in a dengue-endemic country or with a history of travelling to tropical countries warrants a suspicion of dengue infection.

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3.1.2 - Cardiac Pacing, Implantable Cardioverter–Defibrillators and Cardiac Resynchronisation Therapy

Summary

Cardiogenic shock with complete heart block secondary to dengue myocarditis requiring temporary pacing

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3.1.2 - Cardiac Pacing, Implantable Cardioverter–Defibrillators and Cardiac Resynchronisation Therapy

Summary

Cardiogenic shock with complete heart block secondary to dengue myocarditis requiring temporary pacing