In analyzing the ECG strip, the nurse notices a spike before each QRS complex. The patient's heart rate is 70 beats/min. This phenomenon is reflective of
a. 60-cycle electrical interference; check equipment.
b. pacing artifact; the pacemaker is sensing and capturing.
c. electrical artifact; the pacemaker is not sensing.
d. patient movement; check electrodes.
B
The pacing artifact is the spike that is seen on the electrocardiographic tracing as the pacing stimulus is delivered to the heart. A P wave is visible after the pacing artifact if the atrium is being paced. Similarly, a QRS complex follows a ventricular pacing artifact. With dual-chamber pacing, a pacing artifact precedes both the P wave and the QRS complex.
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