Escape-Capture Quadrigeminy

Report:

Sinus rhythm

First degree AV block (PR 0.28”)

Incomplete right bundle branch block

(Slightly) accelerated ventricular (fascicular) rhythm 69 - 72/min

Sinus capture beats

Comment:

The PR interval would probably be shorter without the interfering ventricular rhythm.

The escape-capture designation is somewhat strained in this case - the escape is somewhat accelerated and the “causal” effective bradycardia of the capturing sinus rhythm is not very slow at 56/min. Nevertheless, the situation has some analogy to escape-capture bigeminy and coining fancy names is a temptation in one’s old age.

A psychoanalyst would have probably called this allorhythmia repetition compulsion.

213. 48 year old lady with angina pectoris.

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