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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Onset of Atrial Fibrillation: Mode Switch
Report:Sinus rhythm 76/min 1 Atrial-sensing ventricular pacemaker 3 SVEB, onset of atrial fibrillation 4 Atrial fibrillation with ventricular response 118-124/min 1 Pacemaker inhibition 0 Incomplete left bundle branch block 1 Comment:At first, the p
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
Pacemaker rhythm or LBBB?
Report:Sinus rhythm 87/min 2 Atrial-sensing ventricular pacemaker 8 Comment:The point here is how small the pacing spikes are; they are best seen in L2 and V4, starting small shallow R waves in the latter. I was ready to cross the computer report and wr
Termination of SVT: Pacemaker Escape
Report:Supraventricular tachycardia 165/min 1 Electrical alternans 2 Termination of paroxysm 0 Atrial escape beat (fusion) 2 Pacemaker escape beat 1 Sinus beat (fusion) 2 VEB (last complex) 1 Nonspecific ST/T changes, possible LVH (R2 = 15 mm) 1
AV Dissociation with Interference
Report:Sinus rhythm 1 Borderline right atrial abnormality (RAA) 1 SVEB 1 Ventricular demand pacemaker rhythm 72/min 2 AV dissociation with interference 2 Fusion beat 2 Nonspecific ST/T changes 1 Comment:The sinus P waves march through the first fo
Wobbly Atrial Lead
Report: Sinus rhythm 86/min throughout 2 First degree AV block (PR 0.28”) 2 Left atrial abnormality (LAA) 1 Pacemaker rhythm (P-sensing) 86/min 2 AV interval 0.16” 2 Probable old inferior and septal infarction 1 Comment:The atrial lead became wobbl
Un Unusual Morphology
Report:Sequential AV pacemaker (known ICD) rhythm 59/min 2 Composite (? Fusion) QRS morphology 8 Comment: The ventricular complexes start as expected, with an initial slur of myocardial activation lasting approximately 0.08”. The second half of each co
Physiological Pacing
Report: Pacemaker rhythm 70/min 7 AV sequential pacemaker 2 100% capture 1 Comment: The patient had a DDD (“universal”) pacemaker, now the commonest type implanted1. In this example, both the atria and the ventricles are paced, mimicking the natural s
DDD Pacemaker: Fractured Ventricular Lead
Report:Dual AV pacing 99/min 1 No ventricular capture, atrial 100% pacing 7 Right bundle branch block 2 Comment:The patient arrived to Casualty in sinus rhythm with sinus pauses and both escape and premature SVEBs (Fig 114a). He still had the SSS. The
Pacing Illusion
Report:Sinus rhythm 1 First degree AV block (PR 0.28”) 2 Atrial-sensing pacemaker – no captures 5 Incomplete LBBB (LVH with ST/T changes) 2 Comment:The illusion of pacing is, of course, supported by the patient’s native incomplete LBBB and its left ax