R-on-T Pacing
Report:
Sinus tachycardia 106/min 1
Fixed-rate ventricular pacemaker rhythm 58/min 2
R-on-pacing 3
Fusion beats 3
Nonspecific ST/T changes 1
Comment:
If the spikes go marching through another rhythm there is no way of knowing if they are atrial or ventricular unless a capture occurs. In this case there are six of them: some completely paced, some fusion beats. The fully paced beat in V2-3 starts just after the summit of a native T wave, with unpleasant possibilities.
Usually nothing happens. If it did, there would be some medico-legal considerations I’d rather not think about. One of them (anyway!) is that the patient obviously no longer needs the pacemaker in the first place.
Fig 43. 73 year old man in Casualty with chest pain.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.