ORMC Progressive Care Unit (PCU) Practice Test

What is a common management step for pacemaker oversensing?

Replacing the generator Increasing pacing rate Initiating anticoagulation Adjusting the sensing sensitivity to reduce oversensing

Correct Answer:

Adjusting the sensing sensitivity to reduce oversensing

Explanation:

Oversensing happens when the pacemaker picks up signals that aren’t true heartbeats, causing inappropriate inhibition of pacing or miscounting events. The best management is to adjust the device’s sensing sensitivity to reduce detection of those noncardiac signals. By making the sensing threshold less sensitive (increasing the threshold), the pacemaker is less likely to register noise, T waves, or EMI as valid events, while still reliably sensing true intrinsic beats. This approach directly targets the sensing problem and preserves pacing function. Replacing the generator, increasing the pacing rate, or starting anticoagulation do not address the sensing issue and are not appropriate first steps.

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