Which pacing mode features spikes before both the atrial and ventricular signals, indicating synchronized AV pacing?

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Multiple Choice

Which pacing mode features spikes before both the atrial and ventricular signals, indicating synchronized AV pacing?

The key idea is how pacing spikes reveal which chambers are being paced and whether atrioventricular coordination is preserved. In AV-synchronous dual-chamber pacing, the device has leads in both the atrium and the ventricle. It delivers a spike in the atrium just before the P wave, meaning the atrium is being paced, and then after a short AV delay it delivers a second spike in the ventricle just before the QRS, meaning the ventricle is being paced as well. Seeing spikes before both the atrial activity and the ventricular activity on the ECG is the telltale sign of synchronized AV pacing. If only the ventricle were paced, you’d see a spike before the QRS without a preceding atrial spike. If only the atrium were paced, you’d see a spike before the P wave without a ventricular spike. While pacing the ventricles in a CRT setup can involve both ventricles, the described pattern specifically highlights pacing in both chambers with AV synchrony, which is dual-chamber AV synchronous pacing.

The key idea is how pacing spikes reveal which chambers are being paced and whether atrioventricular coordination is preserved. In AV-synchronous dual-chamber pacing, the device has leads in both the atrium and the ventricle. It delivers a spike in the atrium just before the P wave, meaning the atrium is being paced, and then after a short AV delay it delivers a second spike in the ventricle just before the QRS, meaning the ventricle is being paced as well. Seeing spikes before both the atrial activity and the ventricular activity on the ECG is the telltale sign of synchronized AV pacing.

If only the ventricle were paced, you’d see a spike before the QRS without a preceding atrial spike. If only the atrium were paced, you’d see a spike before the P wave without a ventricular spike. While pacing the ventricles in a CRT setup can involve both ventricles, the described pattern specifically highlights pacing in both chambers with AV synchrony, which is dual-chamber AV synchronous pacing.

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