Unusual demand pacemaker arrhythmia due to partial recycling in the relative refractory period.

Pacing Clin Electrophysiol, 1979/3;2(2):225-9.

Yokoyama M, Wada J, Hirosawa K

PMID: 95285

Impact factor: 1.912

Abstract
This report presents the electrocardiograms of a patient with a normally functioning lithium QRS-inhibited pulse generator that exhibited partial recycling with inappropriately short escape intervals. The occurrence of partial recycling was time-dependent rather than voltage-dependent, and was observed only when QRS complexes fell within the relative refractory period of the pulse generator. This resulted in a complex arrhythmia simulating pulse generator malfunction. This observation re-emphasizes the need for the physician to appreciate the technical characteristics of pulse generators to avoid the unnecessary replacement of normally functioning units.
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