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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Two Rhythms of Indubitably Ventricular Origin
Report: Pacemaker rhythm VEBs Ventricular fibrillation CPR artefact (end of bottom strip) Comment: It has been said (the actual reference eludes me) that the only two rhythms of electrocardiographically certain ventricular origin are ventricular fib
Sinus Bradycardia & AIVR
Report: Sinus bradycardia 37 - 44/min Second degree AV block(unspecified) First degree AV block Accelerated idioventricular rhythm (AIVR) 57/min AV dissociation with interference ST segment elevation consistent with ischæmia/infarction Comment: Thi
Rule of Bigeminy: VEBs & SVEBs
Report: Sinus rhythm First degree AV block (PR 0.26â) Right bundle branch block (QRS 0.14â) VEBs SVEBs, junctional Comment: All four SVEBs follow, after one cycle, the VEBs and the last VEB in the bottom strip follows a SVEB, perhaps reflecting t
Interpolated VEBs & Couplets
Report:Sinus rhythm VEBs, some interpolated, some (bottom strip) in couplets (pairs) Comment:In the top strip, the first VEB blocks the ensuing sinus P wave, creating a fully compensatory pause. The other two penetrate the AV junction retrogradely (conc
Atrial Pacing & Intercalated VEBs
Report: Atrial pacemaker rhythm VEBs, intercalated (interpolated) Comment: The VEBs show the diagnostically important left rabbit ear and different initial vector from the paced beats. They also prolong the subsequent A-R intervals through concealed ret
VEBs Interrupting Flutter Bigeminy
Report: Atrial flutter (tachycardia) 208/min Alternating 4:1 & 2:1 block VEBs (one premature and one escape - fusion - beat) Comment: One and a half supraventricular beats are replaced! The fusion beat counts as only half-replaced. One would also be ac
Movement Artefact
ReportSinus tachycardia 141/min Borderline left atrial abnormality (LAA) Counterclockwise rotation (early transition) Non-specific ST/T changes Movement artefact in standard leads CommentThe artefact in Lead 1 mimics a dimorphic couplet of VEBs, and
Fascicular VT With Retrograde 2:1 Block
Report: Ventricular tachycardia 122/min Retrograde 2:1 V-A block “Retrograde 1o VA block (RP 0.24â)” Comment: The tachycardia originates in the posterior-inferior fascicle of the left bundle branch - it looks like atypical RBBB + LAHB. Despite the r
AIVR: AV Dissociation
Report: Sinus tachycardia 100 - 110/min Accelerated idioventricular rhythm (AIVR) 98/min AV dissociation Fusion beats Comment: Like digoxin, hypokalæmia enhances subsidiary pacemaker automaticity. Even if the AIVR persisted after correction of hypoka
Right Ventricular Outflow Tract Tachycardia
Report:Ventricular tachycardia 165/min Irregular Non-sustained Sinus tachycardia 125/min Comment:This is a fairly typical RVOT tachycardia, with marked right axis deviation (inferiorly directed, from the âroofâ of the RV) and Rosenbaum pattern in