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Pacemaker Ventricular Block
Author(s) -
KISTLER PETER M.,
MOND HARRY G.,
VOHRA JITENDRA K.
Publication year - 2003
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2003.00308.x
Subject(s) - medicine , asystole , cardiology , qrs complex , ventricle , stimulus (psychology) , electrocardiography , heart block , psychology , psychotherapist
Pacemaker ventricular block is a rare and poorly recognized electrocardiographic abnormality usually identified in terminally ill pacemaker patients. Because the patient is frequently moribund and the phenomenon transient, it is probably overlooked and not well documented. It is characterized by an altered temporal relationship between the pacemaker stimulus artifact and the subsequent paced QRS. The most common presentation is a delay or latency between the stimulus artifact and the QRS called first‐degree pacemaker ventricular block. This can then deteriorate to periodic episodes of failure to capture the myocardium referred to as second‐degree pacemaker ventricular block that may manifest as a classical Wenckebach or higher levels of block. Any further deterioration results in a third‐degree pacemaker ventricular block, which is failure to capture the ventricle and asystole. This article describes electrocardiographic examples of this phenomenon. (PACE 2003; 26:1997–1999)