Kazushi Tanaka, Osamu Fujimura Journal of Arrhythmia

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Ventricular asystole due to atrial oversensing by a VVI pacemaker: VVT mode as a simple solution Kazushi Tanaka, Osamu Fujimura Journal of Arrhythmia Volume 28, Issue 5, Pages 288-290 (October 2012) DOI: 10.1016/j.joa.2012.06.002 Copyright © 2012 Japanese Heart Rhythm Society Terms and Conditions

Fig. 1 Ventricular asystole due to oversensing of atrial electrogram in a VVI pacemaker. Arrowheads represent P waves. Note that there were no pacemaker spikes. The paper speed was 25mm/sec. Journal of Arrhythmia 2012 28, 288-290DOI: (10.1016/j.joa.2012.06.002) Copyright © 2012 Japanese Heart Rhythm Society Terms and Conditions

Fig. 2 Inverted chest X-ray image showing the tip of the pacemaker lead placed in the right ventricular inflow close to the tricuspid annulus (1). A temporary pacemaker lead (2) was placed in the right ventricular apex. Journal of Arrhythmia 2012 28, 288-290DOI: (10.1016/j.joa.2012.06.002) Copyright © 2012 Japanese Heart Rhythm Society Terms and Conditions

Fig. 3 Far-field sensing of atrial electrogram by VVT pacing. Note that the atrioventricular interval was constant at approximately 100ms, leading to an increase in ventricular rate from 75 to 100 beats per minute (panels A and B). Panel C shows the development of an intermittent atrial sensing failure (first, second, fifth, and sixth beats); however, ventricular sensing was maintained, thereby eliciting a pacemaker spike within each QRS complex. The third and fourth beats show “appropriate” atrial sensing. V1, V2, V3, and II represent the surface electrocardiographic leads. The paper speed was 25mm/s. Journal of Arrhythmia 2012 28, 288-290DOI: (10.1016/j.joa.2012.06.002) Copyright © 2012 Japanese Heart Rhythm Society Terms and Conditions