However, if your not willing to trust you equipment you'll end up hanging ami on a paced rhythm one day. I've seen it happen. For all of the "treat the patient" BS that exist out their, modern cardiac monitors are pretty dang good. The distrust that exist, and continues to be taught, is often misplaced blame from a bygone era. There are times you absolutely WILL NOT see a spike through the filtering software. As pacers get better, you'll see it less and less.
What I gave was an incredibly oversimplified explanation. Someone once gave me a much more detailed rundown on the ins and outs of modern pacers....and I've forgotten most of it in the ensuing years.
Me too, BUT...the times I've seen this have been randomly and oddly spaced, never correlating with "PVCs" (by your argument there's a bit of artifact at the same point before every PVC that the machine is sensing as a pacer spike? Unlikely). Furthermore the morphology of the ventricular beats appears similar to most of the paced beats I've seen lately. Deep S wave, slight elevation above the baseline of the ST segment, no it's not something I can say is an absolute, but pacer beats, at least in my very anecdotal experience all appear "similar".
All of these are 15 years old. Pacemaker technology and monitor technology has come a LONG, LONG way in 15 years. Back then you were looking at LP10s, very few prehospital 12 leads, non-sensing pacers being commonly, no atrial pacing, ect. It's like comparing a 1997 car to a 2011 car. Not really easy to do.
That said, I could be wrong, cardiology is not a particular area of special interest to me.
