Cardiovascular Collapse Caused by Electrocardiographically Silent 60-Hz Intracardiac Leakage Current

Abstract

Leakage current causes cardiovascular collapse at levels below the VF threshold. Stimulation by silent AC that is neither felt nor visible on the ECG presents as hypotensive VT. In patients with intracardiac electrodes, leakage current less than or equal to the present standard of 50 microA may cause VT or VF. The safety standard for leakage current lasting >/=5 seconds should be </=20 microA. This standard should be based on the continuous-capture threshold.