Key result
Concealed ventricular extrasystoles recorded from a pacing lead were directly observed to cause oversensing without manifest ventricular extrasystoles on the surface EKG.
Case Report (n=1)
This case provides direct observational evidence of concealed ventricular extrasystoles causing pacemaker oversensing and inhibition, a phenomenon previously only theoretically reported.
Alerts clinicians to concealed VEs as a cause of unexplained oversensing; leaves open prevalence and management implications in broader populations.
We report a case of concealed extrasystoles recorded from a pacing lead. The concealed extrasystoles were observed with right ventricular pacing, biventricular unipolar, and biventricular bipolar pacing. The simultaneous surface EKG did not show manifest ventricular extrasystoles with the concealed intracardiac potentials. This case highlights a cause of oversensing that has been theoretically reported in the literature but never directly observed.
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Bowers et al. (2013) conducted a case report in Concealed ventricular extrasystoles producing pacer inhibition (n=1). Right ventricular and biventricular pacing was evaluated on Direct observation of concealed extrasystoles causing oversensing. Concealed ventricular extrasystoles recorded from a pacing lead were directly observed to cause oversensing without manifest ventricular extrasystoles on the surface EKG.
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