McGill Case 224

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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.

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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)