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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Pseudoalternans
Report:Sinus tachycardia 111/min VEBs in bigeminy Fusion beats Comment:The first fusion beat appears at the end of the top strip. The middle strips show VEBs in bigeminy, without fusion; the bottom strip shows later-coupled VEBs in fusion, mimicking al
Adrenaline Bradycardia
Report:Sinus tachycardia 115/min (top) Sinus rhythm 90/min (bottom) VEBs Fusion beats Comment:The rate response is paradoxical, but well documented in normal volunteers. The pressor effect of adrenaline can evoke reflex slowing of the heart rate, over
Chronotropic Incompetence
Report:Atrial fibrillation with âcontrolledâ response Accelerated idioventricular rhythm (AIVR) VEBs Comment:Although the ventricular rate appears favourable, it is in fact inappropriately slow in the setting of shock, pulmonary hypertension (see t
VEA in CVA
Report:Sinus rhythm approx. 65/min Frequent VEBs in couplets, single one interpolated Left bundle branch block QRS 0.14â Comment:The VEBs are narrower in many leads than the LBBB sinus beats; this is not unusual in patients with bundle branch blocks
The Critical Rate
Report: Sinus tachycardia VEBs First degree AV block (PR about 0.24â) Right bundle branch block, rate-dependent Critical rate approx. 124/min Comment: The slight deceleration of the sinus rate from top to bottom reveals the critical rate, about 124
Interpolation and Aberrant Conduction
Report:Atrial rhythm 75/min VEBs, interpolated Rate-dependent incomplete right bundle branch block Nonspecific T wave changes Comment:The actual source of the rhythm is difficult to assign; P inversion in V6 is sometimes held to denote âleft atrial
Transient LBBB with RAD & Prolonged Interpolation Effect
Report:Sinus rhythm and arrhythmia VEBs, interpolated Sustained PR interval prolongation Left bundle branch block Transient right axis deviation post-VEBs Possible old anterolateral infarction Comment:Two things are of interest here: diminuendo PR i
Narrow VEBs & Trifascicular Block
Report:Sinus rhythm 85/min Second degree AV block, unspecified VEBs in bigeminy Right axis deviation +120o Left posterior hemiblock Right bundle branch block Comment:Itâs best to observe the bigeminal VEBs in the rhythm strip: no two are the same.
Alternate-Beat Wenckebach Caused by VEBs
Report:Sinus rhythm 92/min VEBs, couplets and triplets R-on-T phenomenon Wenckebach second degree AV block for alternate P waves Acute or recent inferior infarction Comment:The first two consecutively conducted P waves show slight but definite PR int
Interpolated VEBs in Advanced AV Block
Report: Sinus tachycardia 108/min Second degree, advanced (4:1, 3:1) AV block VEBs, multiform, interpolated Left bundle branch block Comment: The ætiology of the block remained unknown; it could have been due to polyarteritis nodosa through its assoc