Pacemaker wreaking havoc?

[Anjel]

A friend of mine had this patient. I thought it was interesting. Pt was stable all VS were wnl. But these strips were taken within a 15 minute time frame. Interesting how it keeps changing.

 

[chaz90]

Disregard my initial post. I somehow only saw the top picture at first on my phone app.

 

[VFlutter]

Atrial lead is oversensing and most likely too long of a AV delay.

 

[FLdoc2011]

Just looks like it's going back and forth between atrial and ventric pacing (the wide complexes you see). Probably just needs interrogated to be sure all sensing/intervals/thresholds and such are ok.