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Related Concept Videos

Disturbances in Heart Rhythm01:29

Disturbances in Heart Rhythm

Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
Dysrhythmias III: Characteristics of Dysrhythmias01:29

Dysrhythmias III: Characteristics of Dysrhythmias

Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per minute.
Dysrhythmias V: Evaluating Dysrhythmias01:30

Dysrhythmias V: Evaluating Dysrhythmias

Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
Dysrhythmias I: Introduction01:15

Dysrhythmias I: Introduction

Dysrhythmias refers to abnormalities in the heart's rhythm. They result from disruptions in the heart's electrical conduction system, which includes the sinoatrial(SA)node, atrioventricular(AV) node, the bundle of His, bundle branches, and Purkinje fibers.Definition and PathophysiologyDysrhythmias result from disorders of impulse formation, impulse conduction, or both. The heart contains specialized cells in the sinoatrial node, atrioventricular node, and the bundle of His and Purkinje fibers...
Dysrhythmias II: Classification of Tachyarrhythmias01:28

Dysrhythmias II: Classification of Tachyarrhythmias

Tachyarrhythmias are a type of dysrhythmia where the heart rate exceeds 100 beats per minute. Here are some common types of tachyarrhythmias:Sinus TachycardiaSinus tachycardia originates from increased impulses from the sinus node, leading to an elevated heart rate. It is often triggered by stress, fever, or exercise.Patients may experience palpitations, a sensation of a racing heart, dizziness, and chest discomfort.Causes and Risk Factors: Common causes include physical exertion, emotional...

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Related Experiment Video

Updated: Jun 30, 2026

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System
10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

Pacing spikes without visible QRS complexes: Failure to capture?

Antony Gonzales-Uribe1, Malini Madhavan2, Freddy Del-Carpio Munoz2

  • 1NYC Health Hospitals/Jacobi Medical Center, Albert Einstein College of Medicine, New York City, NY, United States of America.

Journal of Electrocardiology
|June 28, 2026
PubMed
Summary
This summary is machine-generated.

Pacemaker telemetry can show artifact, mimicking capture failure. Left bundle branch area pacing in advanced conduction disease requires careful interpretation of pacing signals to avoid misdiagnosis.

Keywords:
Left bundle branch area pacingPseudo-loss of captureTelemetry artifact

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • Advanced Hisian conduction disease necessitates pacing solutions.
  • Left bundle branch area pacing is an emerging technique for cardiac conduction abnormalities.

Purpose of the Study:

  • To investigate an apparent failure to capture during pacemaker implantation.
  • To differentiate true lead malfunction from telemetry artifact in left bundle branch area pacing.

Main Methods:

  • Dual-chamber pacemaker implantation with left bundle branch area pacing.
  • Post-implant telemetry monitoring and device interrogation.
  • Analysis of electrocardiogram (ECG) and pacing signals.

Main Results:

  • Apparent pacing spikes without visible QRS complexes were observed on telemetry.
  • The patient remained asymptomatic with normal device function and capture thresholds.
  • Telemetry processing artifact was identified as the cause, with preserved ventricular activation.

Conclusions:

  • Apparent failure to capture on pacemaker telemetry can be a processing artifact.
  • Unipolar left bundle branch area pacing may present unique telemetry characteristics.
  • Careful review of telemetry and device parameters is crucial for accurate diagnosis.