Search the collection
Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Atrial Fusion Beats
Report:Sinus rhythm Junctional ? atrial rhythm Shifting (atrial) pacemaker Atrial fusion beats AV dissociation Probable third degree AV block Pacemaker rhythm 63/min Comment:Again, this is a "trick" question, designed to make one look (in vain) for
Interpolated VEBs in Advanced AV Block
Report: Sinus tachycardia 108/min Second degree, advanced (4:1, 3:1) AV block VEBs, multiform, interpolated Left bundle branch block Comment: The ætiology of the block remained unknown; it could have been due to polyarteritis nodosa through its assoc
Trigeminal Bradycardia
Report: Sinus tachycardia Advanced second degree AV block 9 second pause Junctional escape beats Comment: Some sinus beats are probably conducted, e.g., first two in the top strip. The long pause is terminated by a junctional escape (first beat in the
Advanced AV Block Following VEBs
Report: Sinus rhythm VEBs Triplet of ventricular tachycardia Advanced second degree AV block Comment: The episodes of ventricular standstill all follow the VEBs. The VEBs appear to have retrograde conduction, which may account for sinus rates being
Valsalva ManÅuvre
Report: Top: Sinus rhythm & arrhythmia Blocked SVEB (first pause) Second degree AV block (second pause) Junctional escape beat Bottom: Sinus rhythm & arrhythmia First degree AV block Sinus arrest Comment: The vagal reflex triggered by the inspi
Junctional Bigeminy & Curious ST Elevation?
Report: Sinus arrest Junctional escape rhythm Bigeminy ? reentry ? different junctional foci ? junctional exit block Post-extrasystolic ST segment elevation Comment: The above diagnoses, reasonable as they may sound, were all wrong. The only person a
Spurious ST Segment Elevation
Report: Sinus bradycardia 43/min Left atrial abnormality First degree AV block Escape-capture bigeminy Third degree AV block (mid-second strip onward) Junctional rhythm 64/min Comment: The broad shallow sinus P waves, with their first degree AV bl
Wenckebach Conduction of Sinus Tachycardia
Report: Sinus tachycardia 116/min SVEB Second degree AV block, Möbitz 1 Comment: Some of the blocked P waves look different in shape from others, due to their position on the preceding T wave. Their timing easily distinguishes them from blocked SVEBs.
Complete Heart Block: Anterior MI
Report: Sinus tachycardia Third degree AV block Ventricular escape beats and rhythm Comment: The slowing of the sinus rate in the forth and fifth strips was ominous, reflecting sinus node hypoxia or ischæmia. The ventricular escapes were slow and unr
Bigeminy and Trigeminy: Atrial Flutter
Report:Atrial flutter 250/min Alternating 4:1 & 2:1 (2:1 + 3:2) conduction, with bigeminy (top) 2:1 + 4:3 conduction, with trigeminy (bottom) Comment:Typical flutter has a basic 2:1 block and a more distal, Wenckebach block; this combination accounts f