AF with Regular Response?
Report:
Atrial fibrillation
Accelerated (idio)junctional rhythm
Comment:
Verapamil is known to âregulariseâ the ventricular response to atrial fibrillation. Completely regular rhythm, however, implies AV block and the presence of an escape pacemaker.
In this instance, the escape pacemaker is slightly accelerated (the intrinsic junctional rate is 40-60/min), probably due to digoxin therapy.
Predictably, when the Surgeon heard the above (his Registrar was quite knowledgeable), he snapped âGet a heart doctor!â and stomped away.
Fig 26. 59 year old teacher with long history of mild palpitations not requiring therapy. He was referred from the Clinic for consideration of permanent pacing re âRBBB with Möbitz II blockâ detected on routine ECG. Leads 1-2-3 from the Clinic are shown below. What do they reveal and what do they conceal?
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