Patient’s clinical data: 78-year-old white man. History of MI, severe CAD, CHF, LBBB, EF 10-15%, complex ventricular ectopy, SVT, and NSVT.
(1.) Based on the patient’s pertinent past medical history as well as the QRS morphology and polarity in lead V1, what kind of implanted device does he have?
(2.) What is the underlying rhythm and which is the best (or only) lead for determining this?
(3.) Is the device behaving normally and functioning properly or is it failing to sense (e.g., oversensing or undersensing)?
(4.) What is causing this bigeminal pattern of paired beats?