Pseudo-cross-stimulation due to first degree AV block.
During routine interrogation of a dual chamber pacemaker, atrial pacing stimulus outputs were found to coincide with surface electrogram QRS complexes raising concern for cross-stimulation. Scrutiny of the native rhythm, however, confirmed this to be "pseudo-cross-stimulation" where marked first degree AV block resulted in alignment of atrial stimulus outputs with preceding QRS complexes. Although cross-stimulation is rare, familiarity with cross-stimulation and pseudo-cross-stimulation is important because its recognition will avoid erroneous diagnoses of lead dislodgment or device malfunction.
Sherev
Dimitri A
DA
Division of Cardiology, California Pacific Medical Center, San Francisco General Hospital, San Francisco, California 94115, USA.
Hongo
Richard H
RH
Goldschlager
Nora
N
D001283:Atrioventricular Node / Q000503:physiopathology; D004562:Electrocardiography; D006327:Heart Block / Q000503:physiopathology* / Q000628:therapy*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial