Interpretation of Pacemaker ECG

Interpretation of Pacemaker ECG
Interpreting pacemaker ECGs Assessing pacemaker function requires knowledge of the mode of pacing, and careful analysis of  ECG  tracings. Most modern devices are capable of transmitting ECG tracings continuously to cloud-based platforms, which enables the clinician to examine intracardiac ECGs at any time. However, most clinicians who encounter patients with pacemakers only have access to conventional surface ECGs. Being able to assess pacemaker function and perform troubleshooting should be considered a basic clinical skill. Pacing activity may be visible or invisible, depending on e.g the type of pacemaker, intrinsic cardiac activity, etc. The cardinal manifestation of pacing on surface ECG is the  stimulation artifact  (Figure 1). In atrial pacing, the stimulation artifact precedes the P-wave. In ventricular pacing, the stimulation artifact precedes the QRS complex. Two artifacts are seen if both chambers are paced. The stimulation artifact is larger in  unipolar pacing , as compared with…

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