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Atrial Pacing example one



Notice the small vertical deflections that precede the P-waves.   These are the pacer spikes, the record of the stimuli an electronic pacemaker is providing.  This pacer is stimulating the atria only, and is getting capture with each stimulus: each spike is followed by a P-wave and then a QRS.  The P-R interval is not excessive, and the QRS duration is consistent with a normally functioning specialized conduction system.   The interval between spikes is 0.60 seconds, so the pacer is set at 100 per minute.  This could be a dual chamber pacer.  We can't tell, because native conduction from the atria to the ventricles is completely satisfactory, so no ventricular stimulation is needed.  This pacer was programmed as AOO (Atrial stimulating, no sensing, no response), but that cannot be told from the strip.  It could just as well have been DDD (Dual stimulating, Dual sensing, Dual response).