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Initiation of pacemaker endless loop tachycardia by triboelectricity

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In the figure below, the three lead ECG on the left shows the initiation of an endless loop tachycardia in a patient with a unipolar DDD pacemaker when the skin over the device was touched at the arrow (low rate 70 ppm, upper rate 150 ppm, atrioventricular delay 170 ms, postventricular atrial refractory period …

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