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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Pretend-Sequential Pacemaker
Report:Pacemaker rhythm 60/min 4 Failed atrial capture 5 Possible retrograde conduction 1 Comment:The atrial spikes precede an empty AV interval – there is no evidence of atrial activity. A trace taken 5 months previously (below) was essentially the sa
Wrong Footprints
Report:Sinus rhythm Non-conducted SVEBs Trigeminy Left bundle branch block Comment:Surprising number of staff reported these strips as Wenckebach (Möbitz 1) second degree AV block. The reason may be the memory of Marriott's injunction to "recognise
Pacemaker Syndrome: Paced Bigeminy
Report:Pacemaker rhythm 71/min 1 AV sequential (probably DDD) pacemaker 2 Reentry paced beats of pacemaker origin 5 Bigeminy 1 No evidence of paced atrial capture 1 Comment:The trace should be compared to the previous one, where each atrial pacing sp
Another Paced Bigeminy
Report:Sinus rhythm 88/min 1 AV block, unspecified 1 DDD pacemaker rhythm 62/min 1 Alternating atrial sensing and pacing 2 Failure to sense alternate P waves 2 Atrial trigeminy 1 Ventricular bigeminy 1 Posterior electrode position 1 Comment:The se
Atrial Pacemaker: Complete Failure to Sense
Report:Sinus/atrial pacemaker rhythm 58-72/min 5 Atrial pacemaker: failure to sense 3 Borderline low voltage in frontal leads 1 Nonspecific ST/T changes, V2-5, consistent with ischæmia 1 Comment:The atrial pacing rate is much slower than the sinus rhy
Profusion of Pseudofusion Beats
Report:Sinus rhythm 70/min 1 Normal trace 2 Demand pacemaker 1 Fusion beat 3 Multiple pseudofusion beats 3 Comment:It just happened that the patient’s sinus rate was 70/min – the rate usually pre-set for permanent pacemakers. There is no pacemaker co
Flutter Bigeminy
Report:Atrial flutter 252/min 2 Alternating 2:1 & 4:1 block 2 Demand pacemaker 1 Pseudofusion spikes in alternate complexes 2 Small voltage, limb leads 1 Possible old anteroseptal infarction 1 Nonspecific ST/T changes 1 Comment:The pacemaker rate i
Flutter with Failed Pacemaker
Report:Atrial flutter 250/min 2 4:1 block 1 Failed pacemaker 3 Poor R wave progression 1 Nonspecific ST/T changes 1 Comment:The intrinsic pacemaker rate is 70/min – the distance from the tip of the sensed R wave to the first pacing spike and also the
Flutter with Paced Tachycardia
Report:Atrial flutter 250/min 4 Electronic pacemaker, atrial-sensing 5 Ventricular rate approximately 120-130/min 1 Comment:The flutter can be made out as the underlying rhythm during pacing in the two longer ventricular cycles: there is an obvious neg
Onset of Pacing With Retrograde Conduction
Report:Sinus rhythm 59-62/min 1 Borderline left atrial abnormality (LAA) 1 Demand pacemaker rhythm 59/min 3 Retrograde conduction 5 Comment:The slight sinus arrhythmia allows the pacemaker takeover at 59/min, following a pseudofusion beat in the midd