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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Sinus Pauses
Report: Sinus rhythm Sinus pauses, probably sinus arrests Atrial escape beats Comment: The first beat in each group has a different-contoured P wave and is probably an atrial escape beat. This prevents the pause being measured, but it is already more t
Classical Wenckebach
Report:Sinus rhythm 82 â 86/min Second degree AV block, Möbitz 1 Left atrial abnormality (LAA) Recent inferior infarction Comment:Most clinically observed Wenckebach periods are in some way atypical; the long ones are so as a rule. The commonest at
Echo Beats
Report: Sinus rhythm (7 beats) Ventricular tachycardia (4-beat run) VEBs, couplet (two beats) Reentry (echo) beats of ventricular origin (two beats) Comment: There are more QRS complexes of ventricular than supraventricular origin here - 8 vs. 7. Both
First Degree AV Block
Report:Sinus rhythm 60/min First degree AV block PR interval 0.62â Indeterminate axis Absolute small voltage Minor T wave changes Comment:The PR interval is considerably longer than the R-P interval, confusing the computer into diagnosing junction
Atrial Fusion Beats
Report:Sinus arrhythmia 64 â 80/min Junctional rhythm 58/min Atrial fusion beats Nonspecific ST/T changes Comment:Three P waves in the middle of the tracing are clearly intermediate in shape between sinus P waves and the junctional retrograde ones;
Möbitz 2 AV Block & Right Bundle Branch Block
Report:Sinus rhythm 90/min Second degree AV block, Möbitz 2 Right bundle branch block Borderline left atrial abnormality (LAA) Comment:All the PR intervals, before and after the block, are 0.16â. This is type 2 block, intraventricular: the LBB is b
Sino-Atrial Exit Block
Report:Sinus rhythm 52 â 54/min Sino-atrial exit block Bigeminy Nonspecific T wave changes Comment:There are two long cycles. One is slightly longer, the other slightly shorter than twice the preceding P-P cycle. Allowing for some sinus arrhythmia,
Sino-Atrial Exit Block
Report:Sinus rhythm 74/min 3:2 sino-atrial exit block Bigeminy Negative U waves in lead 1 Comment:The same comments can be made here as for the preceding Case 93. It, too, could have Möbitz 2 mechanism. Below (Fig 94a) is another trace, with long cy
Unfinished Wenckebach
Report:Sinus rhythm 76/min Wenckebach phenomenon Atrial trigeminy, possible reentry beats of sinus origin, blocked Frequent VEBs, uniform Positive concordant precordial pattern Left atrial abnormality (LAA) Left anterior hemiblock (frontal axis â6
Heart Transplant
Report: Sinus rhythm 92/min Another sinus rhythm, 66/min Atrial âparasystoleâ Small voltage Comment: This was, of course, a âtrick questionâ - except that the answer should suggest itself without even looking at the trace. Not many types of