Elective Replacement Indicator Elective Replacement Indicator This is an interesting tracing that indicates the this pacemaker is at it's elective replacement time.
Note the at the first 4 beats are at 90/min (have slowed from 100/min) and that this is irrespective of the programmed pacing rate. The rate of 62/min after the 4 faster beats suggests the pacer was set at 70/min.
Note the large retrograde P waves after every QRS complex.