September 2018

12 lead ECG post dual chamber pacemaker implant

Jason Collinson – Chief Cardiac Physiologist
Essex Cardiothoracic Centre, Basildon and Thurrock University Hospital
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

THE 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