Pacemaker Arrhythmias and Electrocardiographic Recognition of Pacemakers

Abstract

Adequate interpretation of pacemaker arrhythmias requires a thorough knowledge of the clinical situation in which they appear, the type of pacemaker, and modality of stimulation used, as well as knowledge of the corresponding electronic specifications. At times, this information is essential to reach the correct diagnosis. The significant features of the various (atrial, ventricular, or sequential atrioventricular) pacemakers were stressed placing special emphasis on the most used pacing system, namely, the transvenous QRS-inhibited (demand) ventricular pacemaker. Arrhythmias specific to the latter which could be seen during its normal or abnormal function included magnet-induced vagaries and significant shortening or lengthening of automatic (spike-to-spike) and escape (natural-to-QRS) intervals. Obtaining the maximal efficiency from artificial pacemakers requires the cooperation of patient, manufacturer, cardiovascular surgeon, and clinical cardiologist.