Despite the increasing use of pacemaker therapy, assessment of pacemaker function and electrocardiogram (ECG) interpretation continue to challenge even experienced critical care nurses. Accurate assessment of pacemaker function is essential in the evaluation of patients, especially patients with symptoms that may be related to pacemaker malfunction such as syncope or palpitations. This article will review pacing concepts and pacing system components. A systematic approach to ECG interpretation will be presented that can be used in a variety of clinical settings.

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