PMC4007786_01
Pacing at DDD 65/110 beats per minute. Shown from top to bottom are the lead I, atrial electrogram (A egm), right ventricular electrogram (V egm), and annotations. AP: atrial pacing; AS: atrial sensing; RVP: right ventricular pacing; RVS: right ventricular sensing; LVP: left ventricular pacing. Cross-talk inhibition occurs at the fourth and fifth complex (arrows).
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fig1
However, at the time of device interrogation, the ECG showed intermittent ventricular inhibition.  Figure 1 demonstrates intermittent ventricular sensing followed by inhibition after atrial pacing.
Holter recording showing only atrial pacing spikes without ventricular response resulting in a pause of 7.4 seconds.
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fig2
A Holter recording performed 24 hours prior to the device checkup revealed several periods of asystole with duration up to 7.4 seconds as a consequence of cross-talk sensing (Figure 2).
Restoration of normal function without cross-talk sensing after reduction of the ventricular sensitivity to the least sensitive setting. Abbreviations are similar to Figure 1.
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fig3
Finally, cross-talk sensing disappeared after programming right-ventricular sensitivity from nominal to the least sensitive setting (Figure 3).