Paradoxical undersensing during atrial flutter: what is the mechanism?

J Cardiovasc Electrophysiol. 2006 Nov;17(11):1252-4. doi: 10.1111/j.1540-8167.2006.00571.x. Epub 2006 Jul 27.

Abstract

A patient with congenital complete heart block underwent implantation of a dual-chamber pacemaker. He presented to the emergency room with fatigue and was found to be in atrial flutter. Device interrogation revealed undersensing of 5 mV flutter waves at a programmed sensitivity of 0.5 mV. Due to undersensing, mode switch did not occur. This case illustrates apparently paradoxical undersensing of atrial flutter waves by a dual-chamber pacemaker and can be explained by a phenomenon known as "quiet timer blanking."

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Atrial Flutter / diagnosis*
  • Atrial Flutter / physiopathology*
  • Atrial Flutter / therapy
  • Equipment Failure
  • Humans
  • Male
  • Pacemaker, Artificial / standards*