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Evaluation of intermittent capture in a patient who has undergone an urgent temporary transvenous pacemaker lead insertion
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  1. O Erdogan,
  2. A Altun
  1. Department of Cardiology, School of Medicine, Trakya University, Edirne, Turkey
  1. Correspondence to:
 Dr Okan Erdogan
 İncirli cad Mine ap No: 72/19 Bakırkoy İstanbul, Turkey 34740; okanerdoganyahoo.com

http://dx.doi.org/10.1136/pgmj.2003.011726

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    Answers on p 433.

    A 64 year old woman with a history of hypertension was admitted to our clinic because of recent onset dyspnoea and dizziness. A 12 lead surface electrocardiogram (ECG) showed complete atrioventricular block with an escape rate of 35 beats/min. A transvenous temporary pacemaker lead was immediately inserted through the right femoral vein. Capture threshold was within the acceptable range. During post-procedure observation in the coronary care unit it was realised that the temporary pacemaker was intermittently capturing. A 12 lead ECG was obtained and is shown in fig 1; the fluoroscopic view is shown in fig 2.

    Figure 1
    Figure 1

     Post-procedure paced ECG.

    Figure 2
    Figure 2

     Post-procedure right anterior oblique (RAO) and left anterior oblique (LAO) fluoroscopic views.

    QUESTIONS

    1. Describe the ECG (fig 1).

    2. What do you see in the fluoroscopic view (fig 2)?

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