Search this site:

NOVEMBER 2000:    Contents    Previous   Next

Clin. Cardiol. 23, 857 (2000)

Images in Cardiology

This section edited by Edward A. Geiser, M.D.

Unusual Pacemaker Spikes

Bashir Hanif, M.D., and Krishnamurthy Suresh, M.D.

Cardiology Division, Health Sciences Center, S.U.N.Y. at Stony Brook, New York, USA

During hospitalization, a 66-year-old Caucasian woman admitted to our hospital for treatment of acute bronchitis developed an episode of ventricular tachycardia that proved refractory to therapy, and she expired. Her baseline electrocardiogram and a three-channel electrocardiographic recording during the episode of ventricular tachycardia demonstrate unusual pacemaker spikes (Figs. 1 A and B).

Fig. 1 (A) Baseline electrocardiogram demonstrating sinus rhythm and cardiomyostimulator spikes coinciding with cardiac systole. The cardiomyostimulator has been set to pace at a ratio of 1:2. (B) Electrocardiogram demonstrating cardiomystimulator spikes during ventricular tachycardia

This patient had a past medical history of a myocardial infarction resulting in severe left ventricular dysfunction and had undergone dynamic cardiomyoplasty using the latissimus dorsi muscle. The unusual pacemaker spikes seen represent the drive train of stimuli delivered by the cardiomyostimulator to the latissimus dorsi to assist cardiac mechanical systole.


  1. Letsou GV, Austin L, Grandjean PA, Braxton JH, Elefteriades JA: Dynamic cardiomyoplasty. Cardiol Clin, February 1995;13(1):121–124

NOVEMBER 2000:    Contents    Previous   Next