There is only scant published evidence demonstrating the importance of diagnosing atrial fibrillation (AF) in patients with a ventricularly paced rhythm. This potential pitfall to recognise AF has the implication of devastating outcomes.

This encounter shows a patient with an underlying rhythm of atrial fibrillation (AFib) and 3rd degree heart block undergoing an aortic valve procedure. The patient is on a permanent ventricular pacing device, which causes the pacing spikes (sharp vertical lines) seen just before the QRS complexes.

Beats 3, 6, 8, 10 and 12 are preceded by both atrial and ventricular pacing spikes — sequential A-V pacing. Beats 2, 4, 5, 7 and 11 are preceded by ventricular pacing spikes only. The absence of atrial pacing spikes suggests that the pacemaker is responding to native supraventriclar impulses.

Jan 18, 2005 · Many pacemakers and implantable defibrillators have features designed to prevent AF and to terminate AF with rapid atrial pacing. The evidence to support their use is limited, although these algorithms appear to be safe and usually add little additional cost.

Background There is only scant published evidence demonstrating the importance of diagnosing atrial fibrillation (AF) in patients with a ventricularly paced rhythm. This potential pitfall to recognise AF has the implication of devastating outcomes.

Studies have demonstrated that the use of atrial-based pacing compared with ventricular pacing significantly lowers the incidence of AF but does not improve survival nor heart failure or cardiovascular death. 3 While atrial pacing is effective in preventing development of AF in patients with symptomatic bradycardia, its value as a treatment for ...

Dec 1, 1997 · DDD or AAI pacing is preferable to VVI pacing, particularly in high risk patients for AF, for lowering the incidence of AF after pacemaker implantation. This study demonstrated that intra-atrial conduction delay is also a risk factor for AF.

Jul 2, 2012 · The rate is typical of a paced rhythm. This patient has an AV sequential pacer, but the underlying rhythm was atrial fibrillation with a controlled ventricular response. The A Fib is inhibiting the pacer from making P waves.

Atrial fibrillation (AF) in particular may go unreported. Objectives: To compare the underlying atrial rhythm determined in the pacemaker clinic with the 12-lead ECG interpretation of the atrial rhythm in those who were continuously paced in the ventricle.

Sep 1, 2000 · We hypothesized that the absence of an irregular rhythm in paced patients may result in a decreased recognition of underlying AF, a lower rate of anticoagulation and a higher incidence of cerebrovascular accident (CVA).