case_images: PMC5818722_01
case_images: ECG and pressure waveform at 50 bpm VVI pacing. Each VVI pacing spike captures a QRS wave
case_images: 40981_2016_29_Fig1_HTML.jpg
case_images: PMC5818722_01_40981_2016_29_Fig1_HTML.jpg
case_images: Fig1
case_images: We then attempted to withdraw from CPB and began VVI pacing at 50 bpm (Fig. 1).
case_images: ECG and pressure waveform showing Mobitz type AV block. Each AOO pacing spike captures a P wave, but every third P wave does not induce a QRS wave
case_images: 40981_2016_29_Fig2_HTML.jpg
case_images: PMC5818722_01_40981_2016_29_Fig2_HTML.jpg
case_images: Fig2
case_images: After 30 min, we attempted atrial asynchronous (AOO) pacing, but the patient's atrioventricular (AV) node did not completely conduct supraventricular electrical activity and the ECG showed Mobitz type AV block (Fig. 2); therefore, we elected to maintain VVI pacing.
case_images: ECG and pressure waveform during the first episode of ventricular fibrillation. This ECG shows the R-on-T phenomenon resulting from undersensing of a PVC. A pacing spike hit the T wave (large arrow) following a PVC (small arrow)
case_images: 40981_2016_29_Fig3_HTML.jpg
case_images: PMC5818722_01_40981_2016_29_Fig3_HTML.jpg
case_images: Fig3
case_images: ECG showed Vf (Fig. 3). External defibrillation with 270 J was administered immediately, which resulted in recovery of the electrical rhythm; ventricular pacing was then able to capture ventricular contraction.
case_images: ECG and pressure waveform during the second episode of ventricular fibrillation. This ECG also shows the R-on-T phenomenon resulting from undersensing of a PVC. A pacing spike hit the T wave (large arrow) following a PVC (small arrow) in this episode, as well
case_images: 40981_2016_29_Fig4_HTML.jpg
case_images: PMC5818722_01_40981_2016_29_Fig4_HTML.jpg
case_images: Fig4
case_images: However, within only two minutes of the first Vf, the ECG again showed a Vf waveform (Fig. 4).