Case 22: A 72-Year-Old Man in the Cardiac Clinic
History
Diagnosis
History
A 72-year-old man is in the cardiac clinic:
Diagnosis
- Electronic ventricular pacemaker, rate 53/min
- Underlying sinus rhythm with complete heart block
- One premature ventricular complex
There are regular sinus P waves (rate 67/min), with complete AV block. There is a single chamber ventricular pacemaker, rate 53/min.
This is a VVI pacemaker (the chamber being paced is the Ventricle, the chamber being sensed is the Ventricle, the device senses and
is Inhibited from pacing by the premature ventricular complex.
The QRS is typical of right ventricular pacing: wide QRS, marked left axis deviation, left bundle branch block pattern with negative
QRS in all the precordial leads.
ECG ID: E620