79 year old female patient with GI bleed and hip fracture monitored.
Rhythm analysis indicates ventricular demand pacing. A nonspecific conduction defect is present, indicated by the bizarre and wide QRS complex.
This encounter shows a patient with sick sinus syndrome (SSS) on a ventricular demand pacemaker. The sharp, vertical spikes often seen just before the QRS represent pacemaker activity. Sick sinus syndrome, also known as sinus node disease, causes the heart to become abnormally paced. This can lead to a heart rate which is too slow, too fast, or containing long pauses. A pacemaker is often needed in order to mitigate this syndrome.
Source: PhysioNet MGH071