Atrial lead malposition in a dual chamber (DDD,M) pacemaker.
A model 7000 pacemaker in the DVI mode emitted two stimuli, the first stimulating the right ventricle and the second 110 ms later. The atrial lead was found in the right ventricular outflow tract. The QRS complex produced by the atrial lead fell after the blanking period, and "committed" the ventricular stimulus 110 ms after the "atrial." Intracardiac electrography during the original implant would have enabled proper atrial lead position.
D000368:Aged; D001919:Bradycardia / Q000175:diagnosis; D003951:Diagnostic Errors; D004562:Electrocardiography; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial