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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Controlling the Ventricular Rate: Upper Rate Limit
Report: Atrial fibrillation 5 Paced ventricular response 115 – 119/min 5 Comment:The unit is pacing quite close to its upper rate limit of 120/min, obviously in response to atrial fibrillation (hence no atrial pacemaker activity – it remains suppressed
Pacemaker Rhythm and LBBB
Report: Electronic demand pacemaker rhythm 70/min 2 Atrial fibrillation 2 Left bundle branch block (last 3 beats) 6 Comment: If it were not for the rhythm strip, few would notice the transition from pacemaker to supraventricular rhythm at the end of th
Escape-Capture Bigeminy in AF
Report: Atrial fibrillation 1 High-grade or complete AV block 1 Junctional rhythm 2 Pacemaker rhythm 1 Escape-capture bigeminy 1 Left anterior hemiblock (LAHB) 1 Right bundle branch block 1 Anteroseptal infarction, age uncertain 1 ST/T changes con
Battery Depletion
Report: Atrial fibrillation 1 Third degree AV block 4 Pacemaker rhythm 44/min 1 Probable battery depletion 4 Comment: Most units are programmed to slow the basic rate as the battery becomes depleted; numbers vary. It is not certain, however, that batt
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
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
Slowing Rate with Battery Depletion
Report:Atrial fibrillation 1 Pacemaker rhythm 60/min 2 Possible battery depletion 7 Comment:Battery depletion is usually programmed to manifest itself by slowing to a pre-set rate, in this case 60/min. This patient’s potential problem was in fact dia
Sensing and not Sensing Atrial Fibrillation
Report:AV sequential pacemaker rhythm 60-75/min 5 Atrial fibrillation 5 Comment: For much of the trace the pacemaker is firing through both barrels, unaware that AF precludes any atrial capture. This wastes the battery. On the other hand, having a rapi
Broad-Complex Tachycardia?
Report:Atrial fibrillation with rapid response 186/min Acute inferolateral infarction Comment:The computer and, regrettably, some of the staff pronounced this VT despite some (and by inference, all) complexes being quite thin and the obvious ST segment