Ventricular Fusion Beats
Report:
Sinus rhythm 78/min
Third degree A V block
ldioventricular (fascicular) escape rhythms 39 -48/min
Right & left bundle branch block morphologies "normalised" ventricular fusion beats
Comment:
The two escape foci reside, presumably, in the two bundle branches. Their fusion (fifth beat in the second strip, second last beat in the bottom strip) synchronises the ventricular activation and produces a normal-width complex. This is how two wrongs can produce, in Schamroth's words, a right!
This patient had an acute inferior infarction and was taken (by me) to the X-Ray Department to pace. He resisted the procedure by going into VF three times as the wire entered the ventricle. I decided he did not need pacing after all, and took him back to the CCU, sadder but wiser41. Fortunately, the patient was not visibly affected by the adventure.
Fig 72. 26 year old frequently seen in Casualty. Why?
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