A 82-year old patient with ischemic cardiomyopathy is implanted with a dual chamber defibrillator.
He comes for his six-monthly check-up with the following ECG.
You interrogate his ICD and arrive at the following screen:
Simulator Case: SafeR II
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Concerning his ECG, what is the most likely diagnosis?CorrectIncorrect
We observe that the programmed mode is indeed SafeR-R (AAI <=> DDD).
How much of the time is the RV paced?
The RV is paced % of the time.
Let’s first look at his intrinsic rhythm under “Tests EGM” and “Sensitivity”.
Is he pacemaker dependent?CorrectIncorrect
Now look at the AVB episodes (under AIDA, AV conduct).
What is you diagnosis?CorrectIncorrect
There is the notion that “90% of mode switches to DDD occurs after sensing a signal in the committed period. The R wave sensed in the committed period can be due to an A sensing error or a long PR.”
Evaluate the associated episodes.
What caused the mode switches?CorrectIncorrect
Click on the magnifying glass next to the message: “90% of …” in AIDA -> AV conduct