McGill Case 301

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 300 | Next Case: McGill Case 302

This is a rhythm strip recorded from a man attending the pacemaker follow-up clinic. The Patient had been implanted with a dual chamber pacemaker one month before. The pacer was programed to VVI mode and AAI mode and ECG recordings were made. Also a PA and lateral chest x-ray was taken. The questions are: Is the pacemaker working properly? If not what do you think is wrong ?