Interesting pacemaker strip...

Soumis par marc.strik le
Type de tracés
ECG
Prothèse
ICD
Constructeur
Medtronic

~~Patient was implanted with a dual chamber Medtronic pacemaker because of AV-block after RF ablation for AVNRT.

During device interrogation with testing we see this EGM.

What's going on on this strip? ECG is not connected (noise), EGM is the ventricular channel.

If you know the answer, perhaps you can also answer this question: is the patient at risk for PMTs?

Tracé PDF

Soumis par sylvain.ploux le lun 19/12/2016 - 10:16

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Nice one Marc,

To help I guess you can tell that the test was done in VVI mode, right?

Sylvain

Soumis par marc.strik le lun 19/12/2016 - 11:53

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This was sent to me by a colleague from another hospital so I don't have more information.

But looking at the device behaviour, I assume it's VVI. :)

Soumis par bordacharp le lun 19/12/2016 - 12:39

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Hi Mark, the pacing mode during the threshold test must be VDI 90bpm; when there is a ventricular capture, there is a 1/1 retrograde conduction explaining the aspect VP-AS; when you loose the ventricular capture, you see a slowing of the a trial rhythm ; there is a retrograde conduction, so there is a risk of PMT; at the end of the test permanent pacing mode (DDD) 

Pierre

Soumis par sylvain.ploux le mar 20/12/2016 - 13:27

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Marcus

Unfortunatlty the management of PMT is going to be hard since Medtronic pacemakers need a VP-AS<400ms for a PMT to be recognized. I see that in your case VP-AS is above this limit...

SP