McGill Case 237

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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 an interesting case where a defibrillator was implanted both as a back-up for ventricular tachycardia and for pacing because of bradycardia. What we see here is DDD pacing by the pacemaker which is following the sinus P waves. What we also see is that a slow VT is induced with the ventricular paced beats. The VT terminates spontaneously. The patient's pacer was set to DDI mode a 40 to prevent continuous pacing of the ventricle (the patient had sinus rhythm with a first degree heart block with a rate of 50/min. most of the time) and the Flecainide and Amiodarone were increased.