Pacemaker Blues
Report:
[Code Blue]
Pacemaker rhythm 72/min 1
QRS 0.36” 2
Pacemaker rhythm 72/min 1
QRS 0.20” 2
AV dissociation 2
Accelerated idioventricular rhythm 78-84/min 2
Comment:
The QRS complex width - in paced beats, bundle branch blocks, or VEBs - generally correlates with myocardial disease. This patient’s QRS width is greatly exaggerated by hyperkalæmia, loss of cardiac output and attendant acidosis and hypoxæmia, as in the agonal Case 35. It almost halved with successful resuscitation.
Note also the increased P wave amplitude with correction of hyperkalæmia.
The pacemaker’s sensing function was obviously retained during the AIVR. A magnet would have converted it to paced rhythm, but it would make little sense in this setting – the AIVR’s faster rate was probably more favourable. In fact, the magnet would best be left over the generator, to produce sustained pacing at 100/min if the unit was so programmed.
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.