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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Rate Hysteresis
Report:Sinus rhythm 1 VEBs, multiform 2 Demand ventricular pacemaker 3 Rate hysteresis 3 Fusion beat (top panel) 1 Comment:The VVI pacemaker takes over after the VEBs; the long cycle it terminates corresponds to a rate 50/min, while the subsequent t
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
Allorhythmic Failure to Pace & Sense
Report: Sinus rhythm 59/min 1 First degree AV block 1 Non-specific ST/T changes 1 Demand pacemaker 75/min 2 Trigeminy 1 Intermittent failure to pace 1 Possible intermittent failure to sense 1 Comment: Of every three pacemaker spikes, only one - the
Left Ventricular Epicardial Pacemaker
Report:AV pacemaker rhythm 81/min 2 Unusual axis ? left ventricular electrode 8 Comment:The pacemaker has 100% atrial and ventricular capture. The unusual RAD in the frontal plane and RV1 suggest a left ventricular electrode. This may be deliberate or
Paced Escape - Paced Capture Bigeminy
Report:Sinus rhythm 57/min 0.5 Complete AV dissociation 0.5 Fixed pacemaker rhythm 31/min 3 Demand pacemaker escape rhythm (set at) 60/min 3 Escape-capture bigeminy 3 Comment:The original pacemaker continued to fire at 31/min as before, obviously dev
Holter Monitor: Endless Loop Tachycardia
Report:AV sequential pacemaker rhythm 75/min 1 SVEB, blocked, inhibiting atrial pacemaker 2 Ventricular pacemaker rhythm with 1:1 retrograde conduction 2 Endless loop tachycardia 120/min 3 VEB terminating the endless loop tachycardia 1 AV sequential
Fixed-Rate Pacemaker
Report: Sinus rhythm 1 Left bundle branch block 3 Fixed-rate (asynchronous) ventricular pacemaker 39/min 6 Comment: Large spikes denote a unipolar pacemaker, a feature not seen in temporary pacemakers. The slow rate would normally imply the battery de
Sinus Bigeminy: Sick Sinus Syndrome
Report: Sinus rhythm 1 Bigeminy, probably due to 3:2 sinoatrial exit block 2 Demand pacemaker, bigeminal fusion beats 7 Comment:The differential diagnosis for this rhythm includes sinus extrasystoles, with post-ectopic SA depression, and atypical sinu
Misleading Leads
Report: Sinus rhythm 1 Left atrial abnormality (LAA) 1 LVH with ST/T changes (incomplete left bundle branch block) 2 Electronic pacemaker, probably atrium-sensing; failure to pace 5 Unusual (bamboo) spike morphology 1 Comment: The distance between th