An artificial atrial pacemaker stimulates the atria to generate a rhythm. The most common type is AAI, where the atria are sensed to detect if there is an adequate intrinsic rhythm and pacing is only delivered if required. This causes a pacemaker spike before the p wave.
See also: Pacemakers
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This ECG is from a man in his 50s who presented with chest pain on a background of previous CABG and dual chamber pacemaker. This was the repeat ECG post intervention.
This ECG shows atrial pacing with resolved ST elevation but T wave inversion in inferior leads and upright T wave in aVL. The cause was an inferior and right ventricular MI.