Can a paced rhythm be irregular?

Normal pacemaker rhythms can result in absent pacing activity, irregular pacing and absence of pacing spikes. Diagnosis of pacemaker malfunction on the ECG is very difficult and may be impossible depending on the underlying native rhythm.

Can a pacemaker cause an irregular heartbeat?

Pacemakers can be directly involved in initiating or sustaining different forms of arrhythmia. These can cause symptoms such as dyspnea, palpitations, and decompensated heart failure. Early detection of these arrhythmias and optimal pacemaker programming is pivotal.

How can you tell if you have a pacemaker rhythm?

The pacemaker rhythm can easily be recognized on the ECG. It shows pacemaker spikes: vertical signals that represent the electrical activity of the pacemaker. Usually these spikes are more visible in unipolar than in bipolar pacing.

Can a pacemaker malfunction?

Pacemakers are implanted in patients with rhythmic cardiac problems. These pacemakers can often malfunction and produce a set of symptoms that require timely assessment and rectification.

What are pacing rhythms?

Definition. An electrocardiographic finding in which the cardiac rhythm is controlled by an electrical impulse from an artificial cardiac pacemaker. (

Is atrial paced rhythm normal?

Normal atrial pacing (AAI or AAI[R]). The 12-lead ECG with rhythm strips shows an atrial paced rhythm at a rate of about 92 bpm. The atrial pacing stimulus outputs are readily apparent, and they are followed by capture of the atria evident from the subsequent P wave.

What is pacing in pacemaker?

The two basic functions of the pacemaker system are pacing and sensing. Pacing refers to depolarization of the atria or ventricles, resulting from an impulse (typically 0.5 msec and 2 to 5 volts) delivered from the generator down a lead to the heart.

How can you tell the difference between paced and V paced?

  1. Commonest pacing mode.
  2. Atrial pacing occurs if no native atrial activity for set time.
  3. Ventricular pacing occurs if no native ventricle activity for set time following atrial activity.
  4. Do you measure paced rhythms?

    To measure the rate, use calipers to assess the atrial pacing interval (AP-AP). Pacing rate in a DDD or AAI device refers to the rate of pacing in the atrium. Find the pacing rate by measuring the atrial pacing interval (AP-AP). Pacing rate in a VVI device refers to the rate of pacing in the ventricle.

    Can a paced rhythm be sinus?

    Does this person actually have a pacemaker? He could. This ECG shows normal sinus rhythm, and this does not rule out the presence of a pacemaker. For example, a patient who has a pacemaker with a currently-appropriate native rhythm may have an ECG that looks like the one above.

    Is atrial paced rhythm normal?

    Normal atrial pacing (AAI or AAI[R]). The 12-lead ECG with rhythm strips shows an atrial paced rhythm at a rate of about 92 bpm. The atrial pacing stimulus outputs are readily apparent, and they are followed by capture of the atria evident from the subsequent P wave.

    What does it mean when pacer not capturing?

    Failure to capture (FTC), which means that the pacemaker stimulations do not result in myocardial activation. Failure to pace (FTP), which means that the pacemaker does not stimulate as expected. Oversensing, which means that the pacemaker senses signals that are not true P-waves or R-waves.

    What is the difference between a paced and V paced?

    Atrial pacing occurs if no native atrial activity for set time. Ventricular pacing occurs if no native ventricle activity for set time following atrial activity.

    What rhythms can be paced?

    For pacing readiness (i.e. standby mode) in the setting of acute myocardial infarction (AMI) with the following:

    • Symptomatic sinus bradycardia.
    • Mobitz type II second-degree AV block.
    • Third-degree AV block.
    • New left, right or alternating bundle branch block or bifascicular block.


    What does it mean to have a paced rhythm?

    Definition. An electrocardiographic finding in which the cardiac rhythm is controlled by an electrical impulse from an artificial cardiac pacemaker. (

    How do you know if you have a paced rhythm?


    Pick the lead that has the biggest QRS complexes. And you know the easiest to identify p-waves. When you're trying to interpret those things don't use the hardest.

    How do you identify a paced rhythm?

    This is similar to looking for normal sinus rhythm. If you see a paced spike then you should see a P or QRS immediately following. This indicates that the atria or ventricle have been ‘captured’ and depolarization has occurred.

    Why do paced rhythms have wide QRS?

    The QRS complex is wide due to ventricular depolarization proceeding outside the conduction system. Figure 4. Pacing in the right atrium and the right ventricle.

    Does pacemaker cause wide QRS?

    Ventricular demand pacing appears on the electrocardiogram (ECG) as a single pacemaker spike followed by a QRS complex that is wide, bizarre, and resembles a ventricular beat (waveform 2).

    Can you do an ECG with a pacemaker?

    A pacemaker is indicated when electrical impulse conduction or formation is dangerously disturbed. The pacemaker rhythm can easily be recognized on the ECG.

    What is pacemaker syndrome?

    Pacemaker syndrome is a phenomenon in which a patient feels symptomatically worse after pacemaker placement and presents with progressively worsening symptoms of congestive heart failure (CHF). This is mainly due to the loss of atrioventricular synchrony whereby the pathway is reversed and now has a ventricular origin.

    What is Twiddler’s syndrome?

    The pacemaker-twiddler’s syndrome refers to the permanent malfunction of a pacemaker resulting from manipulation of the pulse generator within its skin pocket [1]. This leads to a rotation of the device, coiling of the lead and its dislodgement, leading to pacemaker failure.

    What is pacing induced cardiomyopathy?

    Pacing induced cardiomyopathy (PICM) is most commonly defined as a drop in left ventricle ejection fraction (LVEF) in the setting of chronic, high burden right ventricle (RV) pacing.