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This contrasts with the pseudofusion beat wherein the pacemaker impulse does not affect the complex of the natural beat of the heart. Pseudofusion beats are normal. Rare or isolated fusion beats caused by pacemakers are normal as well, but if they occur too frequently may reduce cardiac output and so can require adjustment of the pacemaker. [3]
Junctional escape rhythm is a rhythm that still originates in the AV node or bundle of His, but beats at the intrinsic automaticity of the AV node, between 40 and 60 beats per minute. [ 10 ] Accelerated junctional rhythm
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The magnet can interrupt the pacing and inhibit the output of pacemakers. If MRI must be done, the pacemaker output in some models can be reprogrammed. [7] In February 2011, the FDA approved an MRI-safe pacemaker. [8] Extracorporeal shock-wave lithotripsy (ESWL) procedure is safe for most pacemaker patients, with some reprogramming of the pacing.
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In a normal heart beat rhythm, the SA node usually suppresses the ectopic pacemaker activity due to the higher impulse rate of the SA node. However, in the instance of either a malfunctioning SA node or an ectopic focus bearing an intrinsic rate superior to SA node rate, ectopic pacemaker activity may take over the natural heart rhythm. [ 3 ]
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While the sinoatrial node typically regulates the heartbeat during normal sinus rhythm, PACs occur when another region of the atria depolarizes before the sinoatrial node and thus triggers a premature heartbeat, [1] in contrast to escape beats, in which the normal sinoatrial node fails, leaving a non-nodal pacemaker to initiate a late beat.