66 year old female who is 2 days post an aortic valve replacement.
-Left atrial abnormality
-Left bundle branch block
-Pacemaker malfunction, not constantly sensing
Discussion: There is occasional failure to capture here, but this is functional noncapture due to the stimulus being delivered during the ventricular refractory period. The key abnormality is that the pacemaker is failing to sense. This is a VOO epicardial pacing wire.