An 86-year-old woman with a single-chamber pacemaker (VVIR mode with lower rate limit of 70 bpm, 10% hysteresis, and accelerometer sensor with upper rate of 130 bpm) presented to an emergency room in an asymptomatic state after high heart rates were detected on taking a blood pressure measurement. An electrocardiogram was recorded at rest (Figure). The cardiologist was consulted on suspicion of device failure.
What do you think was the diagnosis?
- 1.
The pacemaker sensor was working normally.
- 2.
The pacemaker was working normally; what we see is a rate damping algorithm.
- 3.
The patient had endless-loop tachycardia.
- 4.
This was an automatic search for pacing threshold.
Suggest a diagnosis to this ECG Contest at: http://www.revespcardiol.org/es/electroreto/70/11. The answer will be published in the next issue (December 2017). #EKGchallenge.