{"id":21756,"date":"2016-12-04T06:18:09","date_gmt":"2016-12-04T00:48:09","guid":{"rendered":"https:\/\/cardiophile.org\/?p=21756"},"modified":"2022-05-15T07:20:53","modified_gmt":"2022-05-15T01:50:53","slug":"vvi-pacing-with-ectopic-beat-and-fusion-beat","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/vvi-pacing-with-ectopic-beat-and-fusion-beat\/","title":{"rendered":"VVI pacing with ectopic beat and fusion beat"},"content":{"rendered":"<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/QunirZt5fk8\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<h2><span style=\"color: #008000;\">VVI pacing with ectopic beat and fusion beat<\/span><\/h2>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-32560 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/12\/VVI-pacing-with-ectopic-and-fusion-1.jpg\" alt=\"VVI pacing with ectopic beat and fusion beat\" width=\"1350\" height=\"679\">VVI pacing with ectopic beat and fusion beat: Basic rhythm in this ECG is a paced rhythm, with pacing spikes (pacemaker artefacts) seen immediately before each QRS complex. The QRS complexes have a left bundle branch block pattern with a superior axis, indicating right ventricular apical pacing. An ectopic beat with right bundle branch block morphology has occurred in between, causing the pacemaker to be inhibited, indicating that it is a demand pacemaker working in VVI mode. In VVI mode, the chamber paced and sensed is the ventricle and the response to a sensed beat is inhibition of pacing. After the regular pacing cycle, the next spike (S) occurs, but the QRS has a morphology intermediate between the spontaneous ectopic beat and the paced beat, with a slightly narrower QRS than the paced beat. This is a fusion beat between a paced beat and a spontaneous ectopic beat which has occurred just after the onset of the pacing spike. When a fusion beat occurs during a ventricular tachycardia, they are called <a href=\"https:\/\/johnsonfrancis.org\/professional\/dressler-beats-in-ventricular-tachycardia\/\">Dressler beats<\/a> [1, 2].<\/p>\n<p>The ectopic beat could either have a left ventricular origin due to the RBBB morphology or a supraventricular origin with aberrant conduction. Occasionally, sinus beats can occur during a ventricular tachycardia and are called capture beats. They are recognized by narrow QRS and preceding P waves. Capture beats are more likely to occur in slower ventricular tachycardias.<\/p>\n<p><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li>1.William Dressler, Hugo Roesler. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/0002870352901890\">The occurrence in paroxysmal ventricular tachycardia of ventricular complexes transitional in shape to sinoauricular beats; a diagnostic aid<\/a>. Am Heart J. 1952 Oct;44(4):485-93.<\/li>\n<li>Young RL, Mower MM, Ramapuram GM, Tabatznik B. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/4684121\">Atrial fibrillation with ventricular tachycardia showing \u201cDressler\u201d beats<\/a>. Chest. 1973 Jan;63(1):96-7.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>VVI pacing with ectopic beat and fusion beat VVI pacing with ectopic beat and fusion beat: Basic rhythm in this ECG is a paced rhythm, with pacing spikes (pacemaker artefacts) seen immediately before each QRS complex. The QRS complexes have a left bundle branch block pattern with a superior axis, indicating right ventricular apical pacing. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":53651,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[1213,1298,1558,2743,3180,4219],"class_list":["post-21756","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library","tag-dressler-beats","tag-ectopic-beat","tag-fusion-beat","tag-pacemaker-artefacts","tag-qrs-complexes","tag-vvi-pacing"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>VVI pacing with ectopic beat and fusion beat - no spike for ectopic<\/title>\n<meta name=\"description\" content=\"VVI pacing with ectopic beat and fusion beat: Ectopic beat has no preceding spike, fusion beat has a spike at onset of QRS and has intermediate morphology.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/vvi-pacing-with-ectopic-beat-and-fusion-beat\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"VVI pacing with ectopic beat and fusion beat - no spike for ectopic\" \/>\n<meta property=\"og:description\" content=\"VVI pacing with ectopic beat and fusion beat: Ectopic beat has no preceding spike, fusion beat has a spike at onset of QRS and has intermediate morphology.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/vvi-pacing-with-ectopic-beat-and-fusion-beat\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2016-12-04T00:48:09+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-05-15T01:50:53+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2016\/12\/VVI-pacing-with-ectopic-beat-and-fusion-beat.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1342\" \/>\n\t<meta property=\"og:image:height\" content=\"675\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"VVI pacing with ectopic beat and fusion beat\",\"datePublished\":\"2016-12-04T00:48:09+00:00\",\"dateModified\":\"2022-05-15T01:50:53+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/\"},\"wordCount\":293,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/wp-content\\\/uploads\\\/2016\\\/12\\\/VVI-pacing-with-ectopic-beat-and-fusion-beat.jpg\",\"keywords\":[\"Dressler beats\",\"ectopic beat\",\"Fusion beat\",\"pacemaker artefacts\",\"QRS complexes\",\"VVI pacing\"],\"articleSection\":[\"ECG \\\/ Electrophysiology\",\"ECG Library\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/vvi-pacing-with-ectopic-beat-and-fusion-beat\\\/\",\"name\":\"VVI pacing with ectopic beat and fusion beat - 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