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Figure 1. Ventricular fibrillation in an 83-year-old man after coronary angiography was caused by the "R-on-T" phenomenon, due to a sensing failure on the part of a temporary pacemaker with ventricular pacing, ventricular sensing, and an inhibition response. Paced beats (open arrows) are followed by four normal sinus beats (small arrows), and a paced beat then interrupts the downsloping portion of the T wave because of the failure of the pacemaker to sense the change (large arrow). This paced beat induces ventricular fibrillation. Immediate cardioversion was performed, and there were no sequelae. The patient, who had recently had a . . . [Full Text of this Article] |
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