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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Spike Decay Masking the QRS
Report:Ventricular pacemaker rhythm 65/min 1 Possible battery depletion 2 Intermittent retrograde conduction 4 Sinus rhythm 75/min 1 Probable third degree AV block 2 Comment:The faster sinus rhythm is almost certainly subject to 3o AV block, but the
Acute Anteroseptal Infarction
Report:Sinus rhythm 72/min Acute anteroseptal infarction Leads V1 and V3 transposed Comment:The biphasic P wave in the displaced V1 indicates that the lead is in correct position (on the patient). There are new Q waves in V1 and V2, with ST segment ele
Coronary Spasm in Septic Shock
Report:Top strip: Sinus tachycardia 117/min Strips 2-5: Sinus rhythm 53/min (2nd strip) â 61/min (bottom) 1o and progressive 2o AV block Junctional escape beats Markes ST segment elevation consistent with acute infarction or ischæmia Comment:In
Parkinsonâs Disease & AF
Report: Atrial fibrillation Nonspecific ST/T changes Somatic tremor Comment: The patient had severe, disabling parkinsonism. Atrial activity is difficult to make out, but the irregularly irregular ventricular rate points to atrial fibrillation. Presen
Rhythm Strip Bump: P Wave or Artefact?
Report: Sinus bradycardia 25/min Junctional escape beats Escape-capture bigeminy Right axis deviation Right bundle branch block Old anteroseptal infarction Lateral infarction or ischæmia Possible right ventricular hypertrophy Comment: Congenital
Adenosine-Induced Autogain102
Report: Atrial flutter 320/min with 2:1 block Ventricular standstill (third strip) Continued atrial flutter Escape complexes of unknown origin Resumed 2:1 conduction of flutter (last two strips) Comment: At first the recording looks like the rare but
Parkinsonâs Disease
Report: Sinus rhythm 80/min SVEB Borderline (-30o) left axis deviation Somatic 5/sec tremor consistent with Parkinsonâs disease Comment: Atrial flutter has the same rate â 300/min â as the extrapyramidal tremor of parkinsonism. In this trace, le
Isoelectric Lead 1
Report: Sinus rhythm Third degree AV block Pacemaker rhythm Reversed arms/legs leads! Comment: Flat Lead 1 is virtually pathognomonic of legs/arms reversal. The P waves also assume retrograde polarity (one is seen in the last cycle in leads 1, 2, 3).
Faulty Calibration
Report: Sinus rhythm Faulty standardisation (upper left-hand corner) Sloping ST segment depression probably due to faulty standardisation Comment: The repeat trace in the CCU was completely normal (Fig 201a below). Instead of receiving an apology and