12 lead ECG post dual chamber pacemaker implant

Jason Collinson – Chief Cardiac Physiologist
Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital.
Contact: jason.collinson@nhs.net
Twitter: @cardiacjase

Background
A 60 year old female with second degree AV block associated with dizzy spells had a dual chamber permanent pacemaker implanted.  A post procedure 12 lead ECG was recorded prior to the post implant device check.  The ECG and programmed settings are displayed below.

Mode     DDD
LR/UR    60/130 bpm
Pace/Sensed AV delay  200/180 ms

Figure 1
12 lead ECG recorded immediately on the ward post pacemaker implant

Question
Which of the following answers explains the pacing function seen in the ECG?

 Sequential AV pacing

 Ventricular Safety Pacing

 AV pacemaker lead reversal

 Magnet rate

 Mode switch to VDI mode operation


Answer

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