Key result
Absence of pacing spikes on surface ECG does not reliably indicate pacemaker malfunction.
Why the study?
Differentiating fast ventricular rhythms due to pacemaker-mediated tachycardia versus intrinsic ventricular tachycardia is clinically important but challenging.
Case Report (n=1)
In patients with dual-chamber pacemakers presenting with rapid ventricular pacing, application of a magnet and pacemaker interrogation can differentiate between pacemaker-mediated tachycardia and pacemaker-tracked supraventricular tachycardia.
The ECG shows a fast ventricular rhythm that is not intrinsic as in VT but paced.
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Andrzej M. Okreglicki (2017) conducted a case report in Pacemaker-mediated tachycardia / Atrial flutter with rapid ventricular pacing (n=1). Electrocardiogram and pacemaker interrogation was evaluated. The ECG demonstrates a fast ventricular paced rhythm driven by underlying atrial flutter, highlighting that the apparent absence of pacing spikes on standard ECGs does not indicate pacemaker malfunction.
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