Publish in this journal
Journal Information
Vol. 72. Issue 2.
Pages 166 (February 2019)
Vol. 72. Issue 2.
Pages 166 (February 2019)
ECG Contest
Full text access
Response to ECG, January 2019
Respuesta al ECG de enero de 2019
Pablo Martínez-Vives
Corresponding author

Corresponding author:
, Ana Fernández-Vega, Victoria Cañadas-Godoy
Unidad de Arritmias, Instituto Cardiovascular, Hospital Clínico San Carlos y CIBER de Enfermedades Cardiovasculares, Madrid, Spain
Related content
Rev Esp Cardiol. 2019;72:7710.1016/j.rec.2018.04.030
Pablo Martínez-Vives, Ana Fernández-Vega, Victoria Cañadas-Godoy
This item has received
Article information
Full Text
Download PDF
Figures (2)
Full Text

Figure 1

Figure 2

Intermittent capture of the pacemaker lead can be observed. The lead has become loose in the right ventricular outflow tract, and is manifest as QRS axis deviation during captured beats. Ectopic beats are produced with mechanical and direct myocardial pacing on impact with this structure (response 2, correct). Figure 1 shows a fluoroscopic image in the anteroposterior projection after completion of pacemaker implantation. Figure 2 shows the chest X-ray taken at the onset of capture failures and ventricular tachycardia. A clear displacement of the electrode is observed. Response 1 is incorrect, as a lower axis is observed, which rules out apical pacing. Response 3 is incorrect because supraventricular tachycardia with aberrant conduction would not explain the capture failures observed. Response 4 is incorrect because the ventricular ectopic beats are monomorphic and have a morphology similar to paced beats, and so the there is some relationship with the electrode.

Copyright © 2018. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?