Another Lead 2 Problem: Narrow Pacemaker Escapes
Report:
Sinus bradycardia 38/min
Left atrial abnormality
Pacemaker escape beats
Escape-capture bigeminy
ST/T changes c/c ischæmia
Comment:
Lead 2 rhythm strip (misprinted as lead 1 â we had a machine that always did it) shows narrow paced beats at some distance from their pacing spikes; the interval between the two looks like a baseline drift from the large, unipolar, spike. Elsewhere the paced QRS starts obviously from the spike and is broad enough to have the expected (for RV apical electrode) LBBB/LAD morphology.
There is much to be said for using modified V1 (Marriott lead) for rhythm strips.
288. Stocky 82 year old man on verapamil for chronic hypertension
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