The appearance of the ECG in a paced patient is dependent on the pacing mode used, placement of pacing leads, device pacing thresholds, and the presence of native electrical activity. Features of the paced ECG are: Pacing spikes. The absence of paced complexes does not always mean pacemaker failure as it may reflect satisfactory native conduction. ECG Features. Atrially paced patients often have evidence of 1st degree AV block or Wenckebach conduction on their paced ECG that is not apparent on their baseline tracing.
Pacemaker rhythms Cardiac pacing systems are described by a three- or four-letter code. The first letter indicates the chamber in which pacing stimuli are delivered atrium, A; ventricle, V; or both, D. The second letter indicates the chamber in which sensing of the intracardiac electrical signal is occurring atrium, A; ventricle, V; or both, D. The third letter indicates the response of the device to a sensed signal inhibition of pacing stimulus output, I; triggering [causing to occur] of stimulus output, T; or both, D. The fourth letter, R, indicates that the device is rate adaptive—that is, it uses one or more sensors to achieve increases and decreases in pacing rate to mimic normal physiologic responses to changes in metabolic need. Commonly used sensors are body motion sensors e. VVI R systems Fig.
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