Search the collection
Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Single Lead Dual-Chamber Pacing
Report: Ventricular pacemaker rhythm 90/min (top strip) 2 Atrial pacemaker rhythm 90/min (bottom strip) 2 Switch from ventricular to atrial pacing with decreased output 6 Comment: The report, as written above, appears correct. However, two things are
Pacemaker or LBBB?
Report:Sinus rhythm 65/min 2 Atrial-sensing ventricular pacemaker 8 Comment:This seems unimpeachable, except for lead V1 having the morphology of LBBB (steep descent, slow ascent) instead of expected right ventricular paced or ectopic beat (slow descent
VVI Pacemaker Mime of Atrial Sensing
Report:Pacemaker rhythm 70/min 4 Atrial tachycardia/flutter 210/min 6 Comment: The patient had a VVI pacemaker set at 70/min, precisely because she had almost constant atrial tachyarrhythmias. In this tracing, however, the AV interval appears fixed at
T Wave Sensing
Report:Pacemaker rhythm 60/min 1 No atrial capture 2 No apparent atrial activity 3 Paced extrasystoles at 0.48 – 0.56” coupling; bigeminy ?T wave sensing 4 Comment: One cannot be absolutely sure that there were no retrograde P waves at the time of
Sinus Bigeminy: Sick Sinus Syndrome
Report: Sinus rhythm 1 Bigeminy, probably due to 3:2 sinoatrial exit block 2 Demand pacemaker, bigeminal fusion beats 7 Comment:The differential diagnosis for this rhythm includes sinus extrasystoles, with post-ectopic SA depression, and atypical sinu
High Electrode Tip Irrelevant
Report: AV pacemaker rhythm 89/min, 100% atrial and ventricular capture 2 Positive QRS axis +25o 8 Comment: Post-CABG, the pacemaker leads are “implanted” epicardially. Thus the positive L2 does not denote difficult pacing, instability, or irritabilit
Sensing and not Sensing Atrial Fibrillation
Report:AV sequential pacemaker rhythm 60-75/min 5 Atrial fibrillation 5 Comment: For much of the trace the pacemaker is firing through both barrels, unaware that AF precludes any atrial capture. This wastes the battery. On the other hand, having a rapi
WPW âAâ Mime of Inferoposterior Infarction
Report:Sinus rhythm 68/min Wolff-Parkinson-White type âAâ conduction Comment:The QRS appears narrow and the PR interval normal in several â in fact, most â leads. On the other hand, the latter is completely effaced by a δ wave in V2 and V3. The
Inferior MI: Reciprocal Changes & Remote Ischæmia
Report:Sinus rhythm 71/min Acute inferior infarction Comment:The reciprocal changes, although minuscule in 1 and very modest in aVL, are spread through all the chest leads. This is now thought to reflect a large infarction rather than separate, remote i
Hyperacute Anterior Infarction
Report:Sinus rhythm 66/min Acute anterior infarction Comment:The term hyperacute refers to increase in T wave height at a very early stage of myocardial infarction. The waves need not be large. As Goldberger put it6, âthe amplitude of hyperacute T wav