Two Pacemakers, One Pacing
Report:
Sinus rhythm 1
Third degree AV block 1
Ventricular pacemaker rhythm 62/min 4
Failed dual pacemaker 59/min 4
Comment:
The two pacemakers and the sinus rhythm are completely dissociated from each other. There is no atrial or ventricular capture by the dual pacemaker and it has no effect on the temporary pacemaker actually pacing the ventricles.
Below is the same patient’s admission ECG, in 3o AVB, junctional escape rhythm 33/min and “empty” dual pacemaker spikes at 59/min.
Fig 90a.
Fig 91. Routine pacing of a 62 year old man following uncomplicated CABG. The mode is AAI to provide atrial transport and a narrow QRS. The nursing staff reported intermittent ventricular pacing by the same lead, with a drop in blood pressure as recorded. Were they right?
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