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This case highlights the potential for VDD pacemaker-mediated arrhythmias caused by atrial electrode dislocation leading to undersensing and oversensing of far-field ventricular signals.
A patient is described with an epicardial atrial or P wave synchronous ventricular inhibited VDD pacemaker which had atrial sensing malfunction manifesting as failure of atrial sensing, and atrial sensing of far-field ventricular polarization voltage afterpotentials or ventricular electrograms which mediated pacemaker allorhythms and tachycardias associated with dislocation of the atrial electrode near the right ventricle.
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Charles D. Johnson (1986) studied this question.
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