Dual Chamber Paced Beat/AV Sequential Paced beat   C16, C24, R9

Uses one lead in the right atrium, and the other in the right ventricle. In AV sequential pacing, pacemaker spikes will occur both before the P wave and the QRS complex. However, no pacemaker spike will occur before the P-wave, if the native atrial rate is faster than the programmed lower rate of the pacemaker. There is either a paced or native QRS depending upon the pacemaker’s programming and AV conduction. If paced, the QRS has a left bundle branch block (LBBB) morphology. If there is a native ventricular depolarization, the QRS morphology is normal (unless a native bundle branch block is present).

Rhythm Strip

AV Sequential Pacing

12 Lead EKG