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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:1008 - Vol. 70 Num.11 DOI: 10.1016/j.rec.2017.04.020

ECG, November 2017

Virginia Ruiz Pizarro a,, Carlos Nicolás Pérez García a, Victoria Cañadas Godoy a

a Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
Suggest your resolution to this ECG Contest


An 86-year-old woman with a single-chamber pacemaker (VVIR mode with lower rate limit of 70 bpm, 10% hysteresis, and accelerometer sensor with upper rate of 130 bpm) presented to an emergency room in an asymptomatic state after high heart rates were detected on taking a blood pressure measurement. An electrocardiogram was recorded at rest (Figure). The cardiologist was consulted on suspicion of device failure.


What do you think was the diagnosis?

1. The pacemaker sensor was working normally.

2. The pacemaker was working normally; what we see is a rate damping algorithm.

3. The patient had endless-loop tachycardia.

4. This was an automatic search for pacing threshold.

Suggest a diagnosis to this ECG Contest at: The answer will be published in the next issue (December 2017). #EKGchallenge.

Corresponding author:

1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved