Atrial Pacemaker: Failure to Sense
Report:
Sinus rhythm 89/min 1
PR interval 0.20 sec 1
Atrial demand pacemaker 3
Intermittent failure to sense 4
Right bundle branch block 1
Comment:
There are three atrial pacemaker beats. All three have a very early spike, always in the same spot. They fail to sense the preceding P wave and its QRS and are presumably escaping from the one before: hence the fixed coupling.
The unusual feature here is that there no other spikes in the trace – only three but all three successful.
In the tracing shown below, there is more widespread failure to sense – but not to pace; the only spike finding the atria responsive produces a “SVEB” identical to the three in the original tracing.
This patient does not appear to need pacing any more.
If you have any suggestions for or feedback on this report, please let us know.
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