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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Two Pacemakers, One Pacing
Report:Sinus rhythm 1 Third degree AV block 1 Ventricular pacemaker rhythm 62/min 4 Failed dual pacemaker 59/min 4 Comment: The two pacemakers and the sinus rhythm are completely dissociated from each other. There is no atrial or ventricular capture
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
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
Slowing Rate with Battery Depletion
Report:Atrial fibrillation 1 Pacemaker rhythm 60/min 2 Possible battery depletion 7 Comment:Battery depletion is usually programmed to manifest itself by slowing to a pre-set rate, in this case 60/min. This patient’s potential problem was in fact dia
Pacemaker or LBBB?
Report:Sinus rhythm 65/min 2 Atrial-sensing ventricular pacemaker 8 Comment:This seems unimpeachable, except for lead V1 having the morphology of LBBB (steep descent, slow ascent) instead of expected right ventricular paced or ectopic beat (slow descent
VVI Pacemaker Mime of Atrial Sensing
Report:Pacemaker rhythm 70/min 4 Atrial tachycardia/flutter 210/min 6 Comment: The patient had a VVI pacemaker set at 70/min, precisely because she had almost constant atrial tachyarrhythmias. In this tracing, however, the AV interval appears fixed at
T Wave Sensing
Report:Pacemaker rhythm 60/min 1 No atrial capture 2 No apparent atrial activity 3 Paced extrasystoles at 0.48 – 0.56” coupling; bigeminy ?T wave sensing 4 Comment: One cannot be absolutely sure that there were no retrograde P waves at the time of
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
Sensing and not Sensing Atrial Fibrillation
Report:AV sequential pacemaker rhythm 60-75/min 5 Atrial fibrillation 5 Comment: For much of the trace the pacemaker is firing through both barrels, unaware that AF precludes any atrial capture. This wastes the battery. On the other hand, having a rapi