Change in pacing thresholds causing bradycardia – but what algorithm facilitates this?
Adam Marzetti Invasive Lead Cardiac Physiologist, East Kent Hospital University Foundation Trust, UK
Disclosure: The author has no conflict of interests to declare.
A 73 year old lady with a history of paroxysmal atrial fibrillation (PAF) and sinus node dysfunction, had a dual chamber pacemaker implanted in 2018. In July 2023, she was prescribed Flecainide for ongoing PAF.
In December 2023 she presented to the emergency department with fast AF, and was given intravenous amiodarone. After the rhythm was terminated, she became bradycardic at 40bpm in a junctional escape rhythm (see figure 1).