Pacemaker Stimulation Criticism at ECG (original) (raw)

Cardiac implantable electronic devices' (CIEDs) numbers have grown up worldwide over the last years [1]. At the same time, functions and algorithms' complexity implementation also expanded. It will be therefore more and more frequent for the clinician to deal with pacemaker (PM) ECGs and unusual device behaviors, particularly when they mimic pseudo-malfunctions. In this chapter, we present some examples of challenging electrocardiograms, aiming to show how the clinician, just by analyzing the ECG, could reach or at least suspect the correct diagnosis. 16.1 Case 1 An 82-year-old man with a history of systemic hypertension and previous dual-chamber PM implantation for second-degree atrioventricular (AV) block was referred to our clinic with a suspected PM malfunction. The patient was asymptomatic. ECG is shown in Fig. 16.1a, b.