Basic arrhythmia ventricular paced strip
2 Apr Refers to the location where the pacemaker senses native cardiac electrical activity. Position III: Atrial and ventricular pacing spikes Appropriate discordance in a ventricular paced rhythm A-V sequential pacing — atrial and ventricular pacing spikes precede each QRS complex with % capture.
The Basics of Paced Rhythms
Analyze the strip for failure to capture, failure to sense, oversensing or failure to pace. Comment on the underlying rhythm if it is determinable. Picture. AV sequential pacing with appropriate sensing and capture. Picture. % atrial paced. Picture. % ventricular paced. Picture. Bi-ventricular pacing with underlying flutter.
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Description:Atrial and ventricular pacing spikes are visible before each QRS complex. QRS complexes are broad with a LBBB morphology, indicating the presence of a ventricular pacing electrode in the right ventricle. Example 3 Another example of A-V sequential pacing. Ventricular Pacing Example 4 Ventricular paced rhythm: Ventricular pacing spikes precede each QRS complex except perhaps complex 2 — although the QRS morphology in this complex is identical to the rest of the ECG, suggesting that this beat is also paced No atrial pacing spikes are seen. The underlying native rhythm is probably coarse atrial fibrillation — there are several possible P waves visible in V1 but otherwise the atrial activity is chaotic.