Abstract
This report documents the presence of supernormal conduction in the normal heart. A 26-year-old woman with congenital heart block treated with a fixed-rate permanent pacemaker returned to the hospital with evidence of pacemaker failure. Pacemaker spikes occurred regularly at a rate of 140 per minute, eliciting ventricular responses only when they occurred during the supernormal period of the cardiac cycle. Telemetric cardiac monitoring revealed complete pacemaker capture, at a rate of 140 per minute when the patient was walking. Following replacement of the pulse generator, the pacemaker performed effectively.
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