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A 67-year-old male patient received a pacemaker for syncope. His parameters at check-up were: P/R amplitude 2.8/11 mV and atrial/ventricular threshold 0.875/0.625. The pacemaker was programmed as follows: lower rate 60 bpm; upper tracking rate 130 bpm; sensed AV interval 120 ms; paced AV interval 50 ms; atrial/ventricular sensitivity 0.5/5.6 mV, and atrial/ventricular output 2/2 V. Due to syncope in his history, the rate drop response was also activated: drop size 25 bpm; drop rate 50 bpm; detection beats: 2 beats. Both with an intervention rate of 100 bpm.
The following ECG was recorded during carotid massage (Fig. 1). What is the explanation for this interesting ECG recording?
ECG recording during carotid massage: Lead I, marker channel, ventricular EGM
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Böhm, A., Kiss, R.G., Bogyi, P. et al. Temporary severe bradycardia due to pacemaker programming. Neth Heart J 24, 488 (2016). https://doi.org/10.1007/s12471-016-0855-1
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DOI: https://doi.org/10.1007/s12471-016-0855-1