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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
SVT with Right Bundle Branch Block Aberrancy
Report:SVT 212/min. Right bundle branch block (RBBB). Right axis deviation +120o probably left posterior hemiblock (LPHB). Comment:The likelihood of aberrancy rests with the rSRâ morphology in lead V1 and the absence of any bizarre features. Verapami
WPW âAâ in AF: Positive Concordant Precordial Pattern
Report:Atrial fibrillation with (very) rapid ventricular response. Anomalous conduction (WPW type âAâ) Wolff-Parkinson-White Syndrome Comment:The rate approaches 300/min but is obviously irregular. The trace is pathognomonic of WPW. The positive co
VT Cardioversion: From Bad to Worse
Report: Broad complex (QRS 0.14â) tachycardia 204/min Ventricular fibrillation (post 150 Joule DCC) Sinus bradycardia (post 300 Joule DCC) Normal sinus rhythm Comment: The synchronised countershock fell on the terminal QRS complex, well away from th
Northwest Axis of Ventricular Tachycardia
Report: Ventricular tachycardia 167/min Comment: The diagnosis of VT rests on monophasic R wave in V1, rS in V6 and the bizarre, âNorthwestâ axis in the limb leads. In V1 there is a soupçon of rabbit ears, with the left one taller than the right. I
Arrhythmogenic Right Ventricular Dysplasia
Report: Ventricular tachycardia 162/min Comment: The patient had dilated right atrium and ventricle, with normal, mildly hypertrophied left ventricle. The coronary arteries were also normal. In Casualty, adenosine 6 + 12 mg, verapamil 2.5 mg, then sotalo
Ventricular Tachycardia: A-V Dissociation
Report:Ventricular tachycardia 150/min A-V dissociation Comment:This is, again, a LBBB-like tachycardia with normal axis, in fact diagnosed by the computer as âLBBBâ. This is obviously not the case in view of the slow and notched, laboured descent t
Trigeminal Tachycardia: Alternate Cycle Interpolation
Report: Sinus rhythm 85/min VEBs, interpolated in alternate cycles Trigeminy Comment: The P waves are regular throughout, but the PR intervals alternate, due to interpolation of the VEBs. The LBBB pattern of the VEBs has a characteristically slurred do
Torsade de Pointes?
Report: Sinus/junctional rhythm SVEBs R-on-T VEBs Runs of multiform ventricular tachycardia ? torsade de pointes Comment: The purists are probably correct in reserving the name torsade(s) de pointes for multiform VT with swinging axis and a backgrou
Upright Retrograde P Waves
Report: Ventricular tachycardia 154 - 142/min Retrograde 1:1 conduction Upright retrograde P waves? Spontaneous termination after slowing to 142/min Junctional escape complex Non-specific ST/T changes VEB Comment: The tachycardia resembles, superfi
Retrograde Block in Ventricular Tachycardia
Report:Ventricular tachycardia 118/min 1:1 retrograde conduction (top) Ventricular tachycardia 180/min 2:1 retrograde block (middle) Comment: The retrograde atrial waves are seen as typical sharp upright deflections in MCL1 or V1 (Marriott lead). T