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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
RBBB: Paced Fusion Rhythm
Report:Sinus tachycardia 107/min 1 Atrial-sensing ventricular pacemaker, 100% capture 2 Presumptive right bundle branch block 5 Fusion complexes throughout 2 Comment:This is similar to the delectable deduction in Case 38, except that the pacemaker’s
Pacemaker-Induced Reverse Wenckebach
Report:Sinus rhythm 56 – 58/min 1 Reverse Wenckebach AV conduction 5 Demand pacemaker rhythm 60/min 1 Left atrial abnormality (LAA) 1 LVH with ST/T changes/incomplete LBBB 2 Comment:This may be the first reported case of reverse Wenckebach in a 12-le
Single Lead Dual-Chamber Pacing
Report: Ventricular pacemaker rhythm 90/min (top strip) 2 Atrial pacemaker rhythm 90/min (bottom strip) 2 Switch from ventricular to atrial pacing with decreased output 6 Comment: The report, as written above, appears correct. However, two things are
DDD Pacemaker in Acute Infarction with 2:1 AVB
Report:Sinus tachycardia 124/min 2:1 AV block A-sensing ventricular pacemaker rhythm 62/min Fusion beats Acute or recent inferolateral infarction Comment:My first thought was something exotic: accrochage between the temporary pacemaker and the sinus
Single Failure to Capture
Report:Sinus rhythm 63/min 2 Complete AV dissociation 4 Pacemaker rhythm 80/min 2 Single failure to pace 4 Comment:AV block cannot be accurately diagnosed here: the atrial (sinus) rate is too slow and the ventricular (pacemaker) rate too fast. Just be
Pacemaker Completing the RBBB
Report:Sinus rhythm 70/min 1 Atrial pacemaker rhythm 55/min 2 Failure to sense 3 Capture beats 2 Right axis deviation +95o 1 Right bundle branch block 1 Comment:The atrial pacemaker discharges with complete regularity at 55/min, obviously heedless o
Pseudofusion Beats
Report:Atrial pacemaker rhythm 64/min 2 SVEB 3 Pseudofusion beats 4 Nonspecific ST/T changes 1 Comment:The QRS complexes are normal except for the ventricular pacing spikes at their onset. They are not fusion beats – the SVEB is preceded by an atrial
VVIR & DDDR: Mode Switch
Atrial UndersensingReport:Sinus tachycardia 100/min 1 Atrial-sensing ventricular pacemaker rhythm 100/min (first two cycles) 2 Ventricular pacemaker rhythm, VVIR mode, 98-84/min 5 VEB 1 LAA 1 Comment:The pacemaker picked up and dropped sinus rate rep
Trigeminy
Report: Demand pacemaker rhythm 65/min 2 Hysteresis rate 60/min 3 Intermittent retrograde conduction 2 Sinus capture beats 2 Trigeminy 1 Probable sick sinus syndrome 0 Comment: To comment on the appropriateness of the pacing rate one has to know th
High Electrode Tip Irrelevant
Report: AV pacemaker rhythm 89/min, 100% atrial and ventricular capture 2 Positive QRS axis +25o 8 Comment: Post-CABG, the pacemaker leads are “implanted” epicardially. Thus the positive L2 does not denote difficult pacing, instability, or irritabilit