Pacemaker Rhythms

Lecture about pacemaker ECGs.

1. PacemakerRhythms
Dr. Michael-Joseph F. Agbayani
@HeartRhythmMD

2. Images used are mine or under a creative commons license or public domain.
These slides are licensed under Creative Commons license: Attribution-
NonCommercial-ShareAlike4.0 International License.
http://creativecommons.org/licenses/by-nc-sa/4.0/

3. Images from Steven Fruitsmaak: https://commons.wikimedia.org/wiki/File:St_Jude_Medical_pacemaker_with_ruler.jpg and https://commons.wikimedia.org/wiki/File:St_Jude_Medical_pacemaker_in_hand.jpg
Image from Drjof ECGpedia: http://en.ecgpedia.org/wiki/File:Picture_pacemaker.jpg

4. Pacemaker
Blausen.com staff. "Blausengallery 2014". WikiversityJournal of
Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762

5. Image from AJC ajcann.wordpress.com: https://www.flickr.com/photos/ajc1/8520716268
Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

6. I II III IV V
Chamber(s)
paced
Chamber(s)
sensed
Response to
sensing
Rate
modulation
Multisite pacing
O = None O = None O = None O = None O = None
A = Atrium A = Atrium T = Triggered
R = Rate
modulation
A = Atrium
V = VentricleV = VentricleI = Inhibited V = Ventricle
D = Dual (A+V)D = Dual (A+V)D = Dual (T+I) D = Dual (A+V)

7. acedensedesponseateultisite

8. entricleentriclenhibitate

9. Image from LanzmanRS, Winter J, BlondinD, FürstG, Scherer A, MieseFR, AbbaraS, KröpilP -Korean J Radiol(2011).
"Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."
URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

10. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

11. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

12. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

13. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

14. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

15. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

16. triumtriumnhibitate

17. Image from LanzmanRS, Winter J, BlondinD, FürstG, Scherer A, MieseFR, AbbaraS, KröpilP -Korean J Radiol(2011).
"Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."
URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

18. ECG from James HeilmanMD: https://commons.wikimedia.org/wiki/File:AtrialPacemakerECG.JPG

19. ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg

20. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

21. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

22. ualua
l
ualate

23. Image from LanzmanRS, Winter J, BlondinD, FürstG, Scherer A, MieseFR, AbbaraS, KröpilP -Korean J Radiol(2011).
"Where does it lead? Imaging features of cardiovascular implantable electronic devices on chest radiograph and CT."
URL: https://openi.nlm.nih.gov/detailedresult.php?img=3168803_kjr-12-611-g003&req=4

24. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

25. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/
A
V

26. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

27. ECG from James HeilmanMD: https://commons.wikimedia.org/wiki/File:Duelchamber.JPG

28. ECG from ECGPedia: http://en.ecgpedia.org/wiki/File:Pacemaker2.jpg

29. ECG from ECGPedia: http://en.ecgpedia.org/wiki/File:Pacemaker2.jpg
A
V

30. ECG from James HeilmanMD: https://commons.wikimedia.org/wiki/File:AtrialPacemakerECG.JPG

31. ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg

32. ECG from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands: http://en.ecgpedia.org/wiki/File:DVA0838.jpg
A
V

33. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/ddd_pacing.htm

34. Image from AJC ajcann.wordpress.com: https://www.flickr.com/photos/ajc1/8520716268
Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg
Oversensing
Undersensing Loss of capture

35. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_noncapture.svg

36. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_noncapture.svg

37. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker-malfunction/

38. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Atrial_capture_loss.svg

39. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Atrial_capture_loss.svg
A
V

40. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_undersensing.svg

41. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_undersensing.svg

42. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg

43. Image from ECGPediauser Drj: http://en.ecgpedia.org/wiki/File:Ventricular_oversensing.svg
A
V

44. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/pacemaker_failure.htm

45. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/Pacing%20-%20reversed%20leads.htm

46. Image from Charles Gomersall: https://www.aic.cuhk.edu.hk/web8/Pacing%20-%20reversed%20leads.htm

47. Image from Flickr user Alberto G.:
https://www.flickr.com/photos/albertogp123/5843577306

48. Image from WG de Voogt, MD, via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0968.jpg

49. Image from WG de Voogt, MD, via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0856.jpg

50. Image via ECGPedia, from J.S.S.G. de Jong, MD, and the CCU nurses of AMC , Amsterdam, The Netherlands:
http://en.ecgpedia.org/wiki/File:ECG000020.jpg

51. Image from ECGPedia: http://en.ecgpedia.org/wiki/File:Atrial_malsensing.svg

52. Image from ECGPedia: http://en.ecgpedia.org/wiki/File:Atrial_malsensing.svg
A

53. Image from Ed Burns: http://lifeinthefastlane.com/ecg-library/pacemaker/

54. Image from WG de Voogt, MD via ECGPedia: http://en.ecgpedia.org/wiki/File:DVA0968.jpg

55. Image from EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten BEng, MD.McGillvia
wikimedia: https://commons.wikimedia.org/wiki/File:E00031141_(CardioNetworks_ECGpedia).jpg

56. Image from W.G. de Voogt, MD, PhD, SLAZ, The Netherlands via wikimediaand ECGpedia:
https://commons.wikimedia.org/wiki/File:DVA0923_(CardioNetworks_ECGpedia).jpg

57. Image from EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten
BEng, MD.McGillvia wikimedia: https://commons.wikimedia.org/wiki/File:132_(CardioNetworks_ECGpedia).jpg

58. Image from wikimediauser Jer5150: https://commons.wikimedia.org/wiki/File:AF_with_RVR-Ashmans_phenomenon-RBBB_aberrancy.png

59. Image from Dr. Michael-Joseph F. Agbayani