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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Reversed Atrial & Ventricular Electrodes
Report: Sinus rhythm (non-conducted) 1 Pacemaker rhythm 78/min 1 Reversed A & V leads 5 Intermittent atrial captures with 1o AV block & IVCD (unspecified) 3 Comment: This was a prank by a junior colleague, in this case harmless, but interesting. The v
Delectable Deductive Diagnosis of RBBB/LPHB
Report: Dual chamber pacemaker rhythm 70/min 2 Frontal plane axis –20o 2 Ventricular fusion complexes throughout 3 Probable underlying right bundle branch block with right axis deviation 3 Comment: I make no apologies for the subcontinental flavour of
Failure to Sense
Report:Atrial fibrillation 1 Ventricular pacemaker 1 Failure to sense 2 R-on-T pacing 2 Fusion beat 2 Incomplete right bundle branch block 1 Nonspecific ST/t changes 1 Comment:Failure to sense is only intermittent, since the pacemaker discharge is
Alternating Atrial Transport
Report: AV sequential pacemaker rhythm 78/min 4 Atrial capture in alternate cycles 3 Sinus ? atrial bigeminy in alternate cycles 3 Comment: Nobody would have looked hard at the atrial activity were the alternans not observed on the pressure display.
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
Double Interpolation
Report: Sinus rhythm 64/min 1 Pacemaker rhythm 62/min 1 Failure to sense (interpolated) 3 R-on-T pacing 2 Concealed retrograde conduction 3 Comment: The two rhythms, so to speak, pass through each other in a prolonged handover of the ventricles! Th
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
Paced Rhythm: Primary T Wave Changes
Report:Sequential pacemaker rhythm 1 SVEBs, with atrial-sensed pacing 2 Ventricular fusion 3 Primary T wave inversion in multiple leads 4 Comment:The pattern is that of global T wave inversion, usually not an ischæmic event. The T wave changes in this
Negative Concordant Precordial Pattern
Report: Sinus rhythm 1 Supraventricular ectopic beat 1 AV dissociation 5 Ventricular pacemaker rhythm 75/min with 100% capture 3 Comment: At first it appears that the large (therefore unipolar) pacemaker spikes track the P waves, but the latter gradu