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Utility of the Atrial Endocardial Electrogram Concurrent with Dual‐Chamber Pacing in the Determination of a Pacemaker‐Mediated Arrhythmia
Author(s) -
SHANDLING ADRIAN H.,
CASTELLANET MARK J.,
MESSENGER JOHN C.,
BROWNLEE ROBERT R.
Publication year - 1988
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 - 10.1111/j.1540-8159.1988.tb04990.x
Subject(s) - medicine , cardiology , single chamber , p wave , ventricular rate , electrocardiography , atrial fibrillation , sinus rhythm
A 73‐year‐old male required a permanent pacemaker for complete heart block. After placement of the dual‐chamber pacemaker, the patient developed random, repetitive ventricularly paced coupling at the upper rate limit. The diagnosis made from the surface electrocardiography was one of ventricular tracking of occult (T wave obscured) atrial ectopic activity. Examination of the telemetered atrial electrogram (EGM) revealed a diagnosis of intermittent far‐field atrial sensing of the terminal ventricular depolarization. The value of obtaining an atrial electrogram during dual‐chamber pacing is discussed.