Abstract
Boston Scientific reported that dual chamber INGENIO family pacemakers or cardiac resynchronization therapy pacemakers (CRT-P) may initiate safety mode. Once Safety Mode is activated, telemetry with the programmer becomes unavailable. This case highlights worsening heart failure due to loss of atrioventricular synchronization associated with transition to Safety Mode and VVI pacing. Urgent admission for generator replacement was necessary because mode adjustment was not possible.