ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 73. Num. 4.
Pages 327 (April 2020)

Ecg contest
ECG, April 2020

ECG de abril de 2020

Sara Lozano JiménezJorge Toquero RamosXabier Cía Mendioroz
Rev Esp Cardiol. 2020;73:40910.1016/j.rec.2019.10.020
Sara Lozano Jiménez, Jorge Toquero Ramos, Xabier Cía Mendioroz

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The patient was a 53-year-old woman with congenital heart disease consisting of partial atrioventricular septal defect, corrected in infancy. In light of severe symptomatic mitral valve regurgitation, the mitral valve was replaced with a mechanical prosthetic valve. During the postoperative period, complete atrioventricular block occurred. As this persisted 6 days after the intervention, it was decided to implant a dual-chamber pacemaker, initially programmed in DDDR mode at a minimum frequency of 60 bpm.

Immediately after implantation, the Arrhythmias Unit was alerted due to a paced rhythm at 45 bpm, with the following ECG recorded (figure 1).

Figure 1
(0.19MB).

What do you think was the most likely diagnosis?

  • 1.

    T-wave oversensing

  • 2.

    Switch to DDI mode due to detection of atrial tachyarrhythmia

  • 3.

    Wenckebach behavior on exceeding the maximum tracking rate

  • 4.

    Sinus tachycardia with 2:1 ventricular pacing due to atrial sensing during the postventricular atrial refractory period

Submit your answer to http://www.revespcardiol.org/es/electroreto/73/04. The answer will be published in the next issue (May 2020). #RetoECG.

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