![]() Pacemaker malfunction can occur for a wide variety of reasons, ranging from equipment failure to changes in underlying native rhythm.ĭiagnosis of pacemaker malfunction is challenging and often associated with non-specific clinical symptoms while ECG changes can be subtle or absent. Underlying rhythm left on its own, with a long pause followed by a ventricular escape beat. The ekg strip below shows the first two spikes pacing, then the pacemaker fails to pace. Its absence will result in the underlying rhythm running (if any). It may be the pacemaker battery, the leads or it could be an over sensing problem. In general, you will have no pacing spikes where they need to be. It could be an intermittent problem or failure altogether. There is no particular rhythm to define this. Somehow, the electrodes have no current flowing through them. Spikes are sensing correctly and pace the ventricles.įailure to output (failure to pace) simply means there is no output signal being generated from the pacemaker. (undersensing) shows the first two spikes fire out of place. Sensing issues are identified when there are pacemaker spikes showing up where they do not belong. Which occurs when a foreign signal (non-cardiac) such as a muscle twitch, are mistaken for real cardiac activity. Sensing problems include “undersensing” where the pacemaker fails to sense the native cardiac rhythm. In most cases, sensing problems are less threatening and can be corrected by performing a pacemaker interrogation. ![]() The example below shows the first two ventricular paced beats capture, then the next ![]() This is identified by having pacing spikes present with no resulting QRS, (capture). Failure to capture is when the pacemaker signal fires but there is no response.
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