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Biventricular pacemaker

ECG Basics: Biventricular Pacemaker

Thu, 08/15/2013 - 23:13 -- Dawn

This is a Lead II rhythm strip from a patient with a biventricular pacemaker. The second and sixth beats are PVCs.  In this lead, the pacemaker spikes are very difficult to see, but they are present.  The pacemaker is operating in a "demand" mode for pacing the atria.  Some of the P waves appear to be the patient's own, and some appear to be caused by the pacing stimulus.  For example, the first beat appears to have no pacer spike before the P wave, and the second beat does have one (albeit tiny).  The morphology of the P waves appears to change, also.  

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