Reentry (Echo) Beats of Ventricular Origin
Report:
Sinus rhythm
VEBs
Bigeminal
Couplets & triplets
Retrograde VA conduction
First degree VA block
Wenckebach conduction
Reentry
Post-ectopic sino-atrial depression
Junctional escape beats
Comment:
There are two reentry beats: third last in the top strip and fourth in the bottom strip. Both are preceded by an inverted P wave with RP interval much longer than the previous RP interval. This is the usual setting for reentry to occur. The antegrade conduction time is much shorter here, at 0.14â; it may indicate separate antegrade and retrograde pathways.
The sino-atrial depression sets in with the occurrence of retrograde conduction toward the end of the top strip. Before that, the sinus P waves prevent retrograde conduction by falling on the ST segment of the VEBs.
171. Xylocaine, ordered over the telephone, was reserved for âmultiform VEBs, couplets or runsâ. Should it be given now?
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