T wave sensing with a programmable pacemaker

A patient with a recently implanted programmable pacemaker presented with slowing of the pacemaker discharge rate. At all programmed rates the cycle length of pacing was equal to the programmed cycle length plus the interval from pacing artifact to the midpoint of the T wave. Recordings from the implanted electrode documented that the amplitude of the T wave. Recordings from the implanted electrode documented that the amplitude of the T wave beyound the refractory period of the pacemaker was still sufficient to recycle the pacemaker.