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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Fat QRS Complexes
Report: Sinus rhythm 1 First degree AV block (PR 0.24”) 1 Right bundle branch block (QRS 0.20”) 2 VEBs ? junctional premature beats (QRS 0.20”, one narrower 0.12”) 1 Demand pacemaker 2 LBBB morphology (QRS 0.20”) 0 Fusion beats (narrowest QRS 0.16”,
Atrial Pacemaker: Failure to Sense
Report:Sinus rhythm 89/min 1 PR interval 0.20 sec 1 Atrial demand pacemaker 3 Intermittent failure to sense 4 Right bundle branch block 1 Comment:There are three atrial pacemaker beats. All three have a very early spike, always in the same spot. Th
Triple Hæmodynamic Handicap
Report:Upper strip: Dual pacemaker rhythm 89/min 1 Ventricular pacing, no atrial capture 1 1:1 retrograde (ventriculo-atrial) conduction 1 SVEB, blocked 3 Atrial capture by the atrial lead following the SVEB 1 Lower strip: Dual pacemaker rhythm 89
Implanted Cardioverter-Defibrillator
Report:Implanted cardioverter-defibrillator (ICD) readout 1 Ventricular tachycardia 152 – 162/min 4 Burst overdrive pacing 190-245/min 4 Sinus rhythm 95/min 1 Comment:The patient had numerous runs of VT which failed to activate the ICD because the ra
Double Coupling
Report:Sinus rhythm 100/min 1 VEBs 1 Ventricular demand pacemaker 3 Apparent intermittent failure to sense 4 Right bundle branch block 1 Comment:The odd thing about the pacemaker’s lack of sensing is that all the paced beats occur after – and seem c
Upper Rate Limit
Report:Sinus tachycardia 120/min 0.5 VEBs, one couplet 1 SVEB 1 AV block, probably complete 1 Atrial-sensing ventricular-pacing pacemaker 1 Pauses due to upper rate limit 120/min 4 Fusion beats 1 Left atrial abnormality (LAA) 0.5 Comment: The pa
Atrial Pacemaker & WPW Conduction
Report: Atrial pacemaker rhythm 71/min 3 WPW ‘B’ conduction 7 Comment:The AV (i.e., spike to QRS) interval here is about 0.15”, but the atrial wave itself hugs the QRS complex as expected. It is invisible in some leads (e.g., V3-6) because it is not a
Ignored VEBs in Trigeminy
Report:Sinus rhythm 1 VEBs, trigeminal 3 Atrial-sensing, ventricular-pacing electronic pacemaker 7 Comment: This case is similar to No. 86, where the pacemaker leads cannot “recognise” the slowly rising ectopic R wave. Here, however, it follows the P
Pseudofusion Beats
Report:Atrial pacemaker rhythm 64/min 2 SVEB 3 Pseudofusion beats 4 Nonspecific ST/T changes 1 Comment:The QRS complexes are normal except for the ventricular pacing spikes at their onset. They are not fusion beats – the SVEB is preceded by an atrial
Two Pacemakers, One Pacing
Report:Sinus rhythm 1 Third degree AV block 1 Ventricular pacemaker rhythm 62/min 4 Failed dual pacemaker 59/min 4 Comment: The two pacemakers and the sinus rhythm are completely dissociated from each other. There is no atrial or ventricular capture