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Patient received a dual chamber pacemaker for SSS and dizziness.
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Day 1 check demonstrated the ECG below.
There are 2 pacing spikes at a very short interval from each other (80ms)
The 1st spike appears to be capturing ventricle (broad complex)
Underlying rhythm is sinus, but there does not seem to be a relationship between p wave and paced complex.
Does not appear to be a biventricular device, base on the
paced QRS morphology
This is consistent with atrial lead dislodgment resulting in V safety pacing
Ventricular safety pacing
After each atrial pacing event there is a ventricular blanking period (not after an atrial sensed event). This is to prevent crosstalk.
Crosstalk is defined as the ventricular lead oversensing the atrial pacing arefact, which would result in pacing inhibition.
In a dependent patient, this would result in ventricular standstill.
As a safety mechanism, if a V sensed event occurs in the cross talk window, a backup V stimulus is delivered (80ms) just in case of inhibition.
