مريض لديه منظم ضربات دائم مضبوط على ٧٠ نبضة في الدقيقة. أي ملاحظة تدل على فشل الالتقاط (Failure to capture)؟

A client has a permanent pacemaker set at 70 bpm. Which finding indicates failure to capture?

1. Normal QRS complexes without spikes at a rate of 82
2. No spikes at all with an intrinsic rate of 75
3. A pacing spike not followed by a QRS complex
4. A pacing spike followed immediately by a wide QRS

Answer: C) A pacing spike not followed by a QRS complex. Failure to capture means the pacemaker fires but the heart does not respond, so a spike appears without a QRS. A wide QRS after a spike is normal capture, and no spikes with an intrinsic rate above the set rate is normal inhibition.