Parasystole[!xe "Parasystole" \t "See Ventricular parasystole"!]

Report:

Sinus rhythm

Ventricular parasystole 41 - 43/min

Comment:

The diagnostic feature, unrecognised by the xylocaine pushers, is the variable coupling interval and the fixed interectopic one. And the fusion beat.

Parasystole is, generally, resistant to antiarrhythmic drugs. It should be treated only when known to evolve into parasystolic VT - a very rare circumstance. The patient died two days later from free wall rupture, perhaps propitiated by the convulsions.

More of the same in the strips below (Fig 197a), including an unusual bigeminy. 197a. Periods of parasystolic bigeminy. There are several SVEBs, some blocked (top strip), some aberrant (middle strip). 198. Post-PTCA ECG of 60 year old man with unstable angina ending with acute inferior infarction.

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