STEP 2: Is there a P wave or QRS complex following every pacer spike? This is similar to looking for normal sinus rhythm. If you see a paced spike then you should see a P or QRS immediately following. This indicates that the atria or ventricle have been ‘captured’ and depolarization has occurred.

What does it look like when a pacemaker fails to capture?

On the ECG, failure to capture is identified by the presence of pacing spikes without associated myocardial depolarization. Causes include pacing lead problems, battery or component failure, low pacing voltage or elevated myocardial pacing thresholds, and exit block.

How do I know my pacemaker is working?

You may feel the increase in your heart rate as your activity level rises; this is the pacemaker at work.