Avoid common mistakes on your manuscript.
We noticed an unprecedented sensing error: after a correctly sensed ventricular extrasystole followed by a correctly timed atrial stimulus, a ventricular impulse occurs that is not sensed, then the delivery of a ventricular stimulus can be observed at the set AV delay (225 ms) (Fig. 1). The subsequent stimuli appear to be sensed correctly, judging from the lack of any atrial or ventricular spikes.
IEGM scans eventually revealed the cause of the unexpected sensing error: while the R-wave amplitude exceeded 15 mV with a bundle branch block, we sensed a significantly lower R-wave amplitude with a narrow QRS (5.8–6.3 mV in the last two QRS) (Fig. 2). At a sensitivity of 5 mV, the pacemaker only intermittently sensed a narrow QRS. We have now lowered the ventricular sensitivity to an appropriate level.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
About this article
Cite this article
Bohm, A., Kiss, R.G. & Duray, G.Z. An unexpected finding in a patient with a DDDR-PM. Neth Heart J 22, 255–256 (2014). https://doi.org/10.1007/s12471-014-0552-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12471-014-0552-x