Key result
An abnormal-looking paced ECG with a transient pacing pulse on the T-wave was identified as the pacemaker's operational behavior due to extended AV delay programming.
Case Report (n=1)
Extended AV delay programming in CIEDs can cause complex ECG patterns with seemingly abnormal pacing artifacts on the T-wave.
Extended AV delay may produce T-wave pacing artifacts mimicking malfunction; case report leaves open its recognition in CIED follow-up.
A patient with a dual-chamber pacemaker for sick sinus syndrome was hospitalized for heart failure. The electrocardiography (ECG) during hospitalization displayed seemingly abnormal pacing artifacts. This report focuses on the problem-solving of an abnormal-looking paced ECG and identifies the pacemaker's operational behavior as the underlying reason. • Some CIEDs can be programmed to extend the AV delay to promote intrinsic conduction. • When the lower-rate setting is high, interpreting the ECG can be complex when the AV delay extends. • If long-term ECG recordings are available, they can aid in interpreting complex ECG patterns.
No takes yet. Share an insight, caveat, or question.
Yuta Sudo (2024) conducted a case report in Sick sinus syndrome and heart failure (n=1). Dual-chamber pacemaker with extended AV delay was evaluated on Abnormal-looking paced ECG. An abnormal-looking paced ECG with a transient pacing pulse on the T-wave was identified as the pacemaker's operational behavior due to extended AV delay programming.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: