title: Questionable dysfunction of a dual-Chamber pacemaker in a 17-year-old female: differential diagnoses of missing ventricular beats.
abstract: The case of a 17-year-old female who had been implanted a dual-chamber DDD pacemaker because of third-degree atrioventricular block is reported. There is a history of continued dizziness and even occasional syncopes. At heart rates of 111/min to 124/min, 24-h Holter electrocardiography revealed isolated missing ventricular beats in an otherwise continuous atrially sensed and triggered, ventricularly paced rhythm. Differential diagnoses of a putative pacemaker dysfunction are presented, comprising 2:1-block at maximum programmed heart rate, intermittent lead fracture, anti-pacemaker-mediated tachycardia algorithm, ventricular oversensing, P wave signal undersensing, and atrial oversensing.
authors.forename: Günter
authors.initials: G
authors.lastname: Lehmann
authors.forename: Christof
authors.initials: C
authors.lastname: Kolb
mesh_terms: D000293:Adolescent; D005117:Cardiac Complexes, Premature / Q000175:diagnosis; D002304:Cardiac Pacing, Artificial; D003937:Diagnosis, Differential; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006327:Heart Block; D006352:Heart Ventricles; D006801:Humans; D010138:Pacemaker, Artificial / Q000009:adverse effects; D013610:Tachycardia