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Tachycardia in the presence of a pacemaker

Department of Medicine, Lister Hospital, Stevenage, UK

Correspondence to:
Correspondence to:
Dr Sivakumar;
sivasiva51@hotmail.com

Submitted 7 December 2002
Accepted 9 March 2003

The first 100% of the full text of this article appears below.

A 84 year old woman was admitted with palpitations of a few days’ duration. She had a dual chamber permanent pacemaker (DDD) fitted five years ago for complete heart block. She was tachycardic with a heart rate of around 120 beats/min but haemodynamically stable. A rhythm strip is shown below (see fig 1).

View larger version (8K): [in this window] [in a new window]   Figure 1 Rhythm strip.

1. What is the electrocardiographic diagnosis?
   
2. Is the pacemaker malfunctioning?
   
3. How do you explain the tachycardia with pacing spikes?
   
4. What is the differential diagnosis for tachycardia with pacing spikes?
   
5. What is the management?
   

Relevant Article

Tachycardia in the presence of a pacemaker
Postgrad. Med. J. 2004 80: 122. [Extract] [Full Text] [PDF]