Possibility of lead displacement has to be considered, which is more likely with temporary pacing. Right ventricular (RV) capture management (CM) is available when the device operates in DDD (R), DDI (R), MVP AAI (R)<>DDD (R) or VVI (R) modes. utilized in the calculation of malfunction-free survival probability.
Oversensing may result in total inhibition of output or prolongation of the escape interval. In a singlechamber system, oversensing is recognized by inappropriate inhibition of the pacemaker. In the setting of evolved inferior wall infarction, it is likely that temporary pacing was done for complete heart block, which has now resolved into first degree AV block. A diagram highlighting the different components of a singlechamber pacemaker and ICD is shown in Figure 13. Inhibited mode means that a sensed impulse will inhibit the pacing. Usually demand pacemaker waits for a pause in the basic rhythm before firing as it senses the spontaneous rhythm and works in inhibited mode. Early occurrence again indicates sensing failure. The key understanding here is that sensing can have two outcomes - on sensing an impulse (in the atria OR ventricle OR either) the pacemaker either DOES shoot a pacing zap (to either the atria OR ventricle) or HOLDS BACK from shooting a pacing zap. Rhythm strip shows two additional pacing spikes with ventricular captures, also occurring fairly early after the previous QRS complex.
Oversensing, which means that the pacemaker senses signals that are not true P-waves or R-waves. Failure to pace (FTP), which means that the pacemaker does not stimulate as expected.
Though it has not captured the ventricles, it does not mean capture failure as it has occurred within the QT interval of the previous QRS complex when we expect the ventricles to be refractory. Failure to capture (FTC), which means that the pacemaker stimulations do not result in myocardial activation. The premature occurrence indicates sensing failure. The pacing artefact marked by red arrow has occurred prematurely and has failed to capture the ventricles. The premature occurrence of the pacing spike would indicate a sensing failure of the pacemaker. The spike marked with blue arrow has come a short while after the preceding QRS complex and has captured the ventricles causing a wide QRS complex. Multiple pacemaker spikes or pacing artefacts are visible. Failure to capture is the inability of the pacemaker stimulus to depolarize the myocardium and is recognized on the ECG as visible pacemaker spikes not. The interesting part is evident in the rhythm strip.
What are the findings in this ECG and possible explanations?ĮCG shows PR interval prolongation, Q and ST elevation with T inversion in lead III, small q and T inversion in aVF along with lateral ST depression and T wave inversion indicating an inferolateral myocardial infarction with first degree AV block.
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