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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Advanced 2o AV Block
Report: Sinus rhythm Progressive first degree AV block (top) VEBs Advanced second degree AV block Comment: The 14 second pause follows the VEB, but the ground had been set even before the first VEB: a single blocked P wave is seen at the end of the to
Jarisch-Bezold Reflex
Report: Atrial fibrillation with slow response Junctional escape beat(s) Comment: There is no observable atrial activity, but the patient had atrial fibrillation since admission. The strips could pass, electrocardiographically, for sinus arrest or atria
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
Bilateral Bundle Branch Block (BBBB)
Report:Sinus rhythm 94/min Advanced (4:1) AV block Left bundle branch block Comment:While it is possible that there exist independent AV nodal block and isolated LBB disease, the block as recorded is more likely an expression of BBBB, viz. permanent
First Degree AV Block on Carbamazepine
Report:Sinus rhythm 66/min First degree AV block PR interval 0.48â Normal QRS-T morphology Comment: The patient had hydrocephalus from Dandy Walker abnormality requiring ventriculo-peritoneal shunting and severe epilepsy requiring several drugs,
Concealed Retrograde Conduction
Report:Sinus rhythm 65/min VEBs, mostly interpolated Nonspecific ST/T changes Comment:For comparison, the last VEB blocks the ensuing P wave completely, producing a fully compensatory pause. Other VEBs merely prolong the subsequent PR interval, though
Post-Ectopic Sino-Atrial Depression
Report:Sinus rhythm 74/min SVEBs, one RBBB-aberrant Marked post-ectopic SA depression (overdrive suppression) Left bundle branch block Comment:The 7th beatâs Pâ distorts the T wave of the preceding sinus beat. The pause containing the SVEB is more
Atrial Conduction Defect
Report:Sinus rhythm 62/min First degree AV block PR interval 0.24â Marked left atrial abnormality (LAA) Nonspecific ST/T changes Comment:The striking abnormality is her P wave as seen in lead 1. It is widely notched and 0.20â long. It acounts for
Möbitz 2 Block with Narrow QRS Complexes
Report:Sinus rhythm 90/min Second degree AV block, Möbitz 2 Borderline ST segment depression Comment:This is quite unusual but fulfils perfectly the simplest and most useful definition of Type 2 block: all the PR intervals are the same. Below (Fig 14