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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Pretend-Sequential Pacemaker
Report:Pacemaker rhythm 60/min 4 Failed atrial capture 5 Possible retrograde conduction 1 Comment:The atrial spikes precede an empty AV interval – there is no evidence of atrial activity. A trace taken 5 months previously (below) was essentially the sa
Pacemaker Syndrome: Paced Bigeminy
Report:Pacemaker rhythm 71/min 1 AV sequential (probably DDD) pacemaker 2 Reentry paced beats of pacemaker origin 5 Bigeminy 1 No evidence of paced atrial capture 1 Comment:The trace should be compared to the previous one, where each atrial pacing sp
Another Paced Bigeminy
Report:Sinus rhythm 88/min 1 AV block, unspecified 1 DDD pacemaker rhythm 62/min 1 Alternating atrial sensing and pacing 2 Failure to sense alternate P waves 2 Atrial trigeminy 1 Ventricular bigeminy 1 Posterior electrode position 1 Comment:The se
Pacemaker-Ventricular 2:1 Block
Report:Sinus rhythm 94/min 1 Atrial-sensing ventricular pacemaker rhythm 4 AV block (unspecified) 1 2:1 pacemaker-ventricular block 4 Comment:T wave’s more trouble than it’s worth. One cannot be sure whether we are dealing with sinus rhythm 94/min or
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
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
Flutter with Paced Tachycardia
Report:Atrial flutter 250/min 4 Electronic pacemaker, atrial-sensing 5 Ventricular rate approximately 120-130/min 1 Comment:The flutter can be made out as the underlying rhythm during pacing in the two longer ventricular cycles: there is an obvious neg
Onset of Pacing With Retrograde Conduction
Report:Sinus rhythm 59-62/min 1 Borderline left atrial abnormality (LAA) 1 Demand pacemaker rhythm 59/min 3 Retrograde conduction 5 Comment:The slight sinus arrhythmia allows the pacemaker takeover at 59/min, following a pseudofusion beat in the midd
Agonal Pacemaker Rhythm
Report: Pacemaker rhythm 80/min 4 Broad pacemaker complexes 0.36” suggest hyperkalæmia or agonal rhythm 6 Comment: It was the latter – agonal rhythm. I rang the patient’s physician who told me the patient had by then been allowed to die, in cardiogenic
Iatrogenous 1o AV Block
Report: Sinus rhythm 62/min 1 DDD (universal) pacemaker Atrial-sensing, ventricular-pacing mode 3 Atrial under-sensing in V1-3, with atrial + ventricular paced complex 3 Long A-V interval 0.30” 3 Comment: In programming the A-V sequential pacemakers