Atrial Pacemaker & WPW Conduction

Report:

Atrial pacemaker rhythm 71/min 3

WPW ‘B’ conduction 7

Comment:

The AV (i.e., spike to QRS) interval here is about 0.15”, but the atrial wave itself hugs the QRS complex as expected. It is invisible in some leads (e.g., V3-6) because it is not a native P wave; it is allowed to look different.

Anomalous conduction is essentially the same in sinus or atrial pacemaker rhythm. The anomalous QRS closely resembles, per se, right ventricular ectopic (including paced) beats. However, no ventricular spike is visible. More decisively, pre-implantation ECG showed identical QRS complexes in sinus rhythm (Fig 88a).

The pacemaker (a DDD unit) is present in this patient to allow pharmacological control of potential tachyarrhythmias.

If you have any suggestions for or feedback on this report, please let us know.