McGill Case 224

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 223 | Next Case: McGill Case 225

This is a complex recording. The patient has a Vista DDD pacemaker which is pacing and sensing the atrium and the ventricle. Note that the paced P waves are seen clearly only in the second lead. There is artifact from the programing pulses that change the pacing rate to 60/min. with 6% rate smoothing and an upper rate of 125/mn. Note the effect of the rate smoothing which slows the pacemaker response (seen after the PVC, and later on where the PR interval is stretched)