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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Establishing Pacemaker Dependence the Hard Way
Report: Sinus rhythm 1 Third degree AV block 3 Idioventricular rhythm 2 QT interval 0.86” 1 Sinus arrest 2 Pacemaker rhythm 1 Comment: The surgeon, who got rather flustered when told the heart had stopped, certainly established the diagnosis of thi
Reciprocal Rhythm
Report: Pacemaker rhythm 1 Variable rate 1 First degree AV (0.2 - 0.4”) and VA (0.47 - 0.51”) block 1 Bigeminy due to reentry (echo) beats of pacemaker origin 6 Ventricular conduction delay (unspecified) 1 Comment: All the complexes shown - atrial
Pseudo-Wenckebach in Pacemaker Rhythm
Report:Sinus tachycardia 100/min 1 Atrial-sensing ventricular pacemaker 2 Pseudo-Wenckebach periods 7 Comment:There is no acceleration of the distal chamber because the increases in AV interval are not decremental as in the “natural” Wenckebach; otherw
Atrial-Sensing Pacemaker Fails to Pace
Report:V1 and V3 reversed 1 Sinus rhythm 94-100/min 0.5 Ventriculophasic sinus arrhythmia 2 Atrial-sensing ventricular pacemaker 2 Complete failure to pace 1 2:1 and 3:2 AV block, Möbitz 2 2 Right bundle branch block 1 Borderline ST segment depres
Pacemaker-Ventricular Wenckebach
Report: Sinus rhythm 1 Third degree AV block 3 Pacemaker rhythm 2 Möbitz 1 (Wenckebach) pacemaker-ventricular block 4 Comment: There is an allorhythmic succession of 2:1 and 3:2 sequences. The latter show well-marked prolongation of spike-to-QRS inter
Sensing but not Pacing
Report:Sinus rhythm 100/min 2 2:1 AV block 3 Left atrial abnormality (LAA) 1 Failure to pace in atrial-sensing pacemaker 3 Prolonged QT interval 0.56” 1 Comment:The unit is almost certainly a DDD one, with preserved atrial sensing but no ventricular
Spiky Ventricular Tachycardia
Report: Pacemaker-mediated tachycardia 118/min 10 Comment: In view of the identical complexes in the admission ECG (Fig 81a) it is hard to believe that Casualty staff thought they were treating a genuine VT with amiodarone. Not to mention the same pacing
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
Acute Inferior Infarction: Anterior Reciprocal Changes
Report:Sinus rhythm 82/min First degree AV block PR interval 0.28â Acute inferior infarction Comment:The tracing is remarkable in that both lateral all the precordial leads show reciprocal ST segment depression, more than the previous example in Fig
Right Ventricular Infarction: Right Chest Leads
Report:Sinus rhythm 96/min Möbitz 1 (Wenckebach) AV block 3:2 and 2:1 conduction Acute inferior infarction Right ventricular infarction Comment:V1 and V2 are still there, but reversed, with the right-sided chest lead hook-up. V3R-6R have additional