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This is a DDD pacemaker set at 60 beats/minute
#1 - These beats are the result of A-V sequential pacing and are normal
#2 - Failure to sense atrial depolarization
#3 - Pseudofusion of atria with atrial pacer spike
#4 - Atrial pacer APPEARS AS A FAILURE TO CAPTURE but capture is not possible due to atrial absolute refractory period. This is to be expected and is not a failure to capture.
All of these findings are a result of improper atrial sensing. The cardiologist can increase the atrial sensitivity of the pacemaker and this should result in normal operation. Clinically, these patients do well as long as they have an adequate heart rate.
Updated: February 18, 1998