# A Man With Two Pacemakers: The Mystery of the Electrocardiogram

## TL;DR

A study explores unusual spike signals in electrocardiograms from patients with pacemakers.

## Contribution

The paper identifies unique spike patterns during pacemaker operation not seen in other pacing types.

## Key findings

- Three spike signals were observed during stable pacing periods.
- Fixed spikes occurred at 180 ms intervals during AV delay.
- These signals were distinct from those in CRT and His bundle pacing.

## Abstract

Our findings reported a confusing but interesting clinical practice. In our study, three spike signals are observed during stable pacing periods, with fixed spikes occurring during the AV delay at 180 ms intervals, excluding other operation types such as CRT and His bundle pacing.