In telemetry for a patient with a pacemaker, a pacing spike confirms that the device attempted to pace the heart. Which statement best describes this concept?

• A. A pacing spike confirms the device attempted to pace the heart
• B. A pacing spike indicates an electrical obstruction
• C. A pacing spike means the heart is beating on its own without device
• D. A pacing spike measures oxygen saturation

Answer: (A)

A pacing spike on telemetry shows that the pacemaker fired an electrical impulse to stimulate the heart. It proves the device is actively attempting to pace, not that the heart is beating independently. If capture occurs, you’ll see the appropriate heart activity (an atrial P wave after an atrial spike or a ventricular QRS after a ventricular spike); if not, a spike may appear with no resulting beat, indicating a failure to capture. This concept is distinct from indicators of obstruction in the electrical tracing or measurements of oxygen saturation, which are unrelated to pacing spikes.