Ząbek Andrzej, Małecka Barbara, Dębski Maciej, Boczar Krzysztof, Holcman Katarzyna, Ulman Mateusz, Lelakowski Jacek
Department of Electrocardiology, The John Paul II Hospital, Kraków, Poland.
Department of Electrocardiology, The John Paul II Hospital, Kraków, Poland; Institute of Cardiology, Jagiellonian University Medical College, Kraków, Poland.
J Electrocardiol. 2018 May-Jun;51(3):487-489. doi: 10.1016/j.jelectrocard.2018.01.003. Epub 2018 Feb 17.
The electrocardiogram (ECG) interpretation in patients with cardiac resynchronization therapy (CRT) may be challenging. The difficulty increases if not well-known pacemaker algorithm is turned on. We show a T-wave protection algorithm (LVTP) in a patient with CRT. Accelerated sinus rhythm and intermittent oversensing in left ventricular channel resulted in loss of CRT pacing. The restoration of biventricular pacing occurred when atrial rate decreased. We provide detailed descriptions of the electrocardiogram and intracardiac electrogram. LVTP may confuse ECG examination interpretation, especially in patients with accelerated atrial rhythm and oversensing in left ventricular channel.
