Atrial-Sensing Pacemaker in AF
Report:
Atrial flutter/fibrillation 2
Dual-chamber pacemaker 3
Tachycardia up to 129/min due to atrial (over)sensing 5
Comment:
The pacemaker is programmed to follow – up to a set upper rate limit – atrial activity. This is really meant for sinus rhythm. With atrial tachyarrhythmias, the paced rate may become fast or irregular, as here. The atrial electrode is now only a liability, unless sinus rhythm can be restored and maintained. To report this as oversensing is meaningless, given the chaotic nature of atrial f waves.
As the amplitude of atrial activity is variable, some is not sensed: hence the two (doomed) attempts at AV sequential pacing. Again, this is not the same as undersensing in sinus rhythm.
Toward the end of the recording, the unit is appropriately inhibited by patient’s own conducted QRS complexes. He may not be pacemaker-dependent; the unit was probably implanted for sick sinus syndrome.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and it's records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.