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Triple pacing spikes on QRST: What is the mechanism?
Sudipta Mondal1, N Sharath1, Jyothi Vijay1
1Department of Cardiology, Electrophysiology division, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala 695011, India.
Abstract:
A septuagenarian man underwent dual chamber pacemaker (DDDR - Boston Scientific Massachusetts, U.S.) insertion for a complete heart block. Intra-procedural lead parameters were within normal limits. Frequent multisite origin premature ventricular complexes were noted even on pre-procedural electrocardiogram (ECG). On the follow-up ECG one pacing spike on the QRS of the first beat was followed by two pacing spikes on the T wave with a total of three pacing spikes on the whole QRST of the first complex. What is the mechanism?
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