Tachycardia with alternating pacemaker spikes: Is it pacemaker malfunction?

J Electrocardiol. 2019 Mar-Apr:53:28-30. doi: 10.1016/j.jelectrocard.2018.12.012. Epub 2018 Dec 18.


A 67 year old female with diabetes mellitus type 2, chronic kidney disease, ischemic cardiomyopathy, status post biventricular implantable cardioverter-defibrillator presented to the Heart Failure clinic for routine follow up with a tachycardia with alternating pacemaker spikes.

Keywords: Abnormal ECG; Accelerated junctional rhythm; Biventricular ICD; Blanking period; Digoxin toxicity; Heart failure.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Comorbidity
  • Defibrillators, Implantable*
  • Electrocardiography
  • Female
  • Humans
  • Tachycardia, Ventricular / physiopathology*