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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Physiological Pacing
Report: Pacemaker rhythm 70/min 7 AV sequential pacemaker 2 100% capture 1 Comment: The patient had a DDD (“universal”) pacemaker, now the commonest type implanted1. In this example, both the atria and the ventricles are paced, mimicking the natural s
Atrial-Sensing Pacemaker in AF
Report: Atrial flutter/fibrillation 2 Dual-chamber pacemaker 3 Tachycardia up to 129/min due to atrial (over)sensing 5 Comment: The pacemaker is programmed to follow – up to a set upper rate limit – atrial activity. This is really meant for sinus rhyth
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
Atrial Sensing & Undersensing
Report:Atrial-sensing & pacing ventricular pacemaker rhythm 60/min 3 Atrial premature beats, possibly sinus 3 Blocked or sensed with first degree AV block or not sensed 3 Atrial bigeminy 1 Comment:All the QRS complexes are paced. The morphology of t
Pacemaker-Ventricular 4:3 Block
Report: Sinus rhythm 1 Atrial-sensing ventricular pacemaker 3 Trigeminy due to 4:3 pacemaker-ventricular block 6 Comment:The paced beats show the expected RV apical pacing morphology of LBBB with LAD. The reason for the intermittent failure to pace is
Atrial Sensing and Pacing
Report:Sinus rhythm 75/min 1 VEB 1 Atrial-sensing ventricular pacemaker 3 Atrial sensing and pacing ventricular pacemaker (last beat) 4 Left atrial abnormality (LAA) 1 Comment:This is a DDD pacemaker, responding to both the atrial activity and the la
Pseudofusion Beats
Report:Atrial pacemaker rhythm 64/min 2 SVEB 3 Pseudofusion beats 4 Nonspecific ST/T changes 1 Comment:The QRS complexes are normal except for the ventricular pacing spikes at their onset. They are not fusion beats – the SVEB is preceded by an atrial
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