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Ventricular pacing with false pacing spikes -- 7-10.
Understanding this phenomenon requires the answers to two questions: First, why were the pacing spikes not inhibited?
The surface Electrocardiogram (ECG) showed unipolar pacing spikes without capture (Fig. 1).
VT was identified as a series of regular electrical deflections recurring at high frequencies independent of any pacing spikes that were present.
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As the system is unable to track the catheter location in real time, a voltage map of the pacing spike (pacing spike voltage map) can localize the pacing stimulus as a surrogate marker for catheter location (displayed as a red dot on the map in Figure 2).
Each VVI pacing spike captures a QRS wave Fig. 2 ECG and pressure waveform showing Mobitz type AV block.
A pacing spike hit the T wave (large arrow) following a PVC (small arrow) in this episode, as well.
Each AOO pacing spike captures a P wave, but every third P wave does not induce a QRS wave.
A pacing spike hit the T wave (large arrow) following a PVC (small arrow) Fig. 4 ECG and pressure waveform during the second episode of ventricular fibrillation.
The systolic decrease in LVI started immediately after the pacing spike or the R-wave detection in the LV, which generally occurred in the late phase of the QRS complex.
Their best trick: properly pacing their releases to maximize the download spikes that come with.
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