TY - GEN ID - cogprints4807 UR - http://cogprints.org/4807/ A1 - Alasti, Mohammad A1 - Haghjoo, Majid A1 - Alizadeh, Abolfath A1 - Sadr-Ameli, Mohammad Ali Y1 - 2006/04// N2 - The 12-lead ECG shows sequential atrial and ventricular pacing (Figure 1A). A tracing, obtained simultaneously during pacemaker interrogation, disclosed pacemaker functioning as VDD mode (Figure 1B). The careful examination of this pacemaker tracing showed that there is a pacing stimulus before each P wave (compatible with DDD mode). This paradox can only be explained by displacement of the temporary pacing lead to right atrium and right atrial stimulation by temporary pacemaker. In this setting, each temporary pacemaker-induced atrial depolarization is tracked by the right atrial lead of the permanent pacemaker as intrinsic P wave. Fluoroscopic study confirmed this explanation (Figure 2). The displaced temporary pacing lead was seen near the lateral right atrial wall. Temporary pacemaker lead had been inserted before replacement of permanent pacemaker. PB - Indian Pacing and Electrophysiology Group KW - Concealed malfunction; temporary pacemaker TI - Concealed Malfunction of The Temporary Pacemaker SP - 133 AV - public EP - 134 ER -