Inappropriate spikes on telemetry? PART 2

Same patiënt as previous case, a 81-year old patient with a sick sinus syndrome and a dual chamber Medtronic pacemaker, admitted due to chest pains.

Last night he showed the following telemetry strip:

What are your ideas?

Physician advice: 
Non
Trace category: 
ECG
Device/Field: 
ICD
Company: 
Medtronic
Sylvain Ploux's picture

Marc,

Please save this guy because he is a very useful source of EGM troubleshooting.

I suspect this has something to do with an automatic Atrial Capture Management algorithm (2 atrial spikes at 70ms interval).

Sylvain