Search the collection
Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Junctional Extrasystoles with RBBB Conduction
Report:Sinus rhythm 81/min 1 Atrial-sensing ventricular pacemaker 3 AV interval 0.10 sec 1 Junctional premature beats with RBBB conduction 4 ST/T changes consistent with ischæmia 1 Comment:Like in the previous case, there are large ventricle-pacing s
Failing Pacemaker
Report: Sinus rhythm 1 Probable third degree AV block 1 AV dissociation 1 Ventricular escape beats 1 Primary T wave changes 1 Probable old anterior infarction 1 Pacemaker rhythm 72/min 1 Intermittent failure to pace 1 Probable lead displacement 2
Isorhythmic Dissociation of a VVI Pacemaker
Report:Sinus rhythm 70/min 1 Ventricular pacemaker rhythm 70/min 4 AV interval 0.36 sec 5 Comment:The sinus P waves are not very well shown in the frontal leads, but there’s no doubting them in the chest leads V1-3. The AV interval is long, but constan
Masquerading Bundle Branch Block
Report:Atrial fibrillation with ventricular response 80-120/min 1 Fixed-rate ventricular pacemaker rhythm 50/min 2 Fusion beat (third paced complex) 1 R-on-T pacing 1 Right bundle branch block 1 Left anterior hemiblock 1 Standard masquerading bundl
Onset of Atrial Fibrillation: Mode Switch
Report:Sinus rhythm 76/min 1 Atrial-sensing ventricular pacemaker 3 SVEB, onset of atrial fibrillation 4 Atrial fibrillation with ventricular response 118-124/min 1 Pacemaker inhibition 0 Incomplete left bundle branch block 1 Comment:At first, the p
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 Tachycardia with Spike Alternans
Report:AV sequential pacemaker tachycardia 120/min 8 Pacemaker spike alternans 2 Comment:The patient refused to stay in Casualty and went home. He returned several days later, when his pacemaker was “interrogated”. No malfunction was found in this DDDR
Allorhythmic Failure to Pace & Sense
Report: Sinus rhythm 59/min 1 First degree AV block 1 Non-specific ST/T changes 1 Demand pacemaker 75/min 2 Trigeminy 1 Intermittent failure to pace 1 Possible intermittent failure to sense 1 Comment: Of every three pacemaker spikes, only one - the
Pacemaker Blues
Report: [Code Blue] Pacemaker rhythm 72/min 1 QRS 0.36” 2 Pacemaker rhythm 72/min 1 QRS 0.20” 2 AV dissociation 2 Accelerated idioventricular rhythm 78-84/min 2 Comment: The QRS complex width - in paced beats, bundle branch blocks, or VEBs - gener
Voluntary Asystole
Report: Pacemaker rhythm 70/min 2 Somatic tremor 4 Pacemaker inhibition by myopotentials 4 Comment: Unipolar pacemakers are more likely to be inhibited by myopotentials than bipolar ones. Muscle inhibition is rarely seen in modern pacemakers (this on