High Electrode Tip Irrelevant
Report:
AV pacemaker rhythm 89/min, 100% atrial and ventricular capture 2
Positive QRS axis +25o 8
Comment:
Post-CABG, the pacemaker leads are “implanted” epicardially. Thus the positive L2 does not denote difficult pacing, instability, or irritability – as it would if the lead were endocardial.
The rate is set at about 90/min in the immediate postoperative period by default. It seems to improve cardiac output in cold, depressed and sometimes beta-blocked patients.
Fig 99. 73 year old man with permanent pacemaker and recent worsening of congestive cardiac failure.
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