Low-Atrial Pacemaker

Report:

Atrial pacemaker rhythm 70/min 2

Retrograde P wave pattern 7

Nonspecific T wave changes

1

Comment:

At first I thought the electrode had been inserted into the coronary sinus. It turned out the heart had been paced more conventionally through the right ventricular apex until it became dislodged (probably pulled by some staff member, or the patient himself) into the right atrium. It continued to pace from there. A chest X-ray confirmed its new location. There were no arrhythmias.

The retrograde P waves are explained by the low electrode tip position in the right atrium.

By the time this happened the patient did not need the pacemaker any longer and it was removed.

Fig 41. 75 year old lady, asymptomatic following cardiac surgery. The computer report was: “Electronic pacemaker, ventricular capture”.

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