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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Long Latency
Report: Sinus rhythm Latent (first degree) AV block PR 0.90â Left anterior hemiblock Right bundle branch block Old anterior infarction Comment: This is the longest sustained first degree AV block I have seen. It is possible that the rhythm is othe
Interpolated Main-Stem Extrasystoles
Report:Sinus rhythm 80/min Interpolated junctional or bundle of His (main-stem) extrasystoles Allorhythmic triplets Left bundle branch block Primary T wave changes Comment:There is a regular sinus rhythm, even though the initial impression may be of
Vagal Vagaries
Report:Sinus rhythm Second degree AV block, Möbitz 1 Ventriculophasic effect in 2:1 conduction (top strip) Period of advanced (high-grade) second degree AV block Comment:Either Wenckebach (Möbitz 1) or Möbitz 2 AV block can progress from "low-grad
Illusion of Sinus Tachycardia
Report:(Lead 2 sequential rhythm strips) Sinus rhythm approximately 96/min Frequent VEBs, some in triplets or short runs of VT Concealed retrograde conduction Comment:This is a good example of the reciprocal R-P â P-R relationship. Much of the lower
Cherchez le P!
Report: Sinus rhythm Second degree AV block, Möbitz 1 Acute inferior infarction Comment: The title is part Marriottâs famous phrase on how to tackle arrhythmias95; it paraphrases the once even more famous cherchez la femme, now squashed by the polit
Sino-Atrial Wenckebach
Report: Sinus rhythm Left atrial abnormality (LAA) 5:4 and 4:3 sino-atrial exit block, Möbitz 1 Normal QRS/T Comment: In each pause, an entire P-QRS-T sequence is missing; the pause itself is less long than two sinus cycles. There is slight accelerat
PAT with Block: Pacemaker Lead
Report:Atrial tachycardia 138/min Second degree AV block, Möbitz 1; 2:1 & 3:2 block Right atrial electrode recording (bottom strips) Comment:The question is a "trick" one, designed to implicate the spurious change in the heart rate in the patient's pr
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
Blocked P Wave Long After a SVEB
Report:Sinus rhythm 79/min First degree AV block PR 0.24â SVEB (Atrial premature beat) Scond degree AV block, unspecified Nonspecific ST/T changes Post-ectopic ST/T changes, postponed Comment:Is it significant that the unexpectedly blocked P wave
Classical Wenckebach Trigeminy
Report:Sinus rhythm 98/min Second degree AV block, Möbitz 1, with 4:3 conduction Trigeminy Left atrial abnormality (LAA) Left bundle branch block Atypical repolarisation pattern suggests ischæmia Comment:The patient had low-therapeutic digoxin lev