Cornelia was working with a patient who had a recently implanted bi-ventricular pacemaker. The EP PA had been in and evaluated the patient and her telemetry. Cornelia was still bothered by the appearance of the patient's rhythm strip. The telemetry screen was picking up pauses on the strip. The patient's QRS waves were varying between groups of wide and groups of narrower complexes. Cornelia went back to the PA and told him that there was "just not something right" about the rhythm. On further review, the PA realized that the pacemaker was not working properly. It was a difficult change to detect because of the lack of visible spikes with this new type of pacemaker. The different complexes were being alternately generated by pacing in the two different ventricles. Because of Cornelia's keen assessment skills and persistence, she was able to facilitate a better outcome for this patient. The pacemaker representative was called back in and made adjustments to improve the pacemakers function. In the PA's words, he "couldn't believe what a great pick up she made. She's a smart one"! We think so too. It is because of Cornelia's consistent outstanding performance and patient advocacy that we feel she is deserving of a DAISY award.