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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
Alternating Paced and Fusion Beats
Report: Slow atrial or junctional rhythm 38/min 2 Ventricular pacemaker rhythm 79/min 2 Superior electrode placement 2 Fusion in alternate beats 2 Presumptive RBBB 1 ST/T changes of uncertain significance 1 Comment: The narrower (0.12 sec) complexes are p
Sinus Captures with 1o AV Block
Report:Sinus rhythm approx. 86/min 1 Second degree AV block, unspecified 2 AV pacemaker rhythm 60/min 1 No atrial capture 2 Sinus captures with 1o AV block 2 Left anterior hemiblock + IVCD 1 LVH with ST/T changes 1 Comment:The space between the atr
Retrograde Wenckebach and Reentry
Report:Pacemaker rhythm 92/min 1 Retrograde Wenckebach conduction 4 Wenckebach sequences terminated by reentry (echo) beats of pacemaker origin 4 Non-specific T wave changes 1 Comment:The pacemaker is in its rate-responding mode at 92/min, with Wenck
Single Failure to Capture
Report:Sinus rhythm 63/min 2 Complete AV dissociation 4 Pacemaker rhythm 80/min 2 Single failure to pace 4 Comment:AV block cannot be accurately diagnosed here: the atrial (sinus) rate is too slow and the ventricular (pacemaker) rate too fast. Just be
Wobbly Atrial Lead
Report: Sinus rhythm 86/min throughout 2 First degree AV block (PR 0.28”) 2 Left atrial abnormality (LAA) 1 Pacemaker rhythm (P-sensing) 86/min 2 AV interval 0.16” 2 Probable old inferior and septal infarction 1 Comment:The atrial lead became wobbl
Atrial Pacemaker Captures During 2:1 AV Block
Report: Sinus rhythm 0.5 AV sequential (known DDD) pacemaker 0.5 Atrial sensing & pacing 1.0”escape interval 1 AV interval 0.30” atrial-paced beats and one conducted sinus beat 1 Failed ventricular pacing 1 Second degree AV block 2:1 alternate paced
No Pacing and 2:1 Failure to Sense
Report:Sinus rhythm 55/min 1 Demand pacemaker: failure to pace 2 2:1 failure to sense 5 LVH voltage (SV2 25mm) 0.5 Left atrial abnormality (LAA) 0.5 Old inferior infarct 0.5 Possible old anterior infarct (loss of R height from V2 to V3) 0.5 Commen
End-of-Life Pacemaker Function
Report:Sinus rhythm 75 – 77/min 1 Third degree AV block 2 Pacemaker rhythm 31/min 2 Probable battery depletion 5 Comment:Pacemaker interrogation revealed “end-of-life” battery function, set to bipolar VVI mode at 63/min, but obviously firing at half t
VEBs in Bigeminy
Report: Sinus rhythm 67 – 71/min 1 Ventricular pacemaker 1 VVI mode 4 Ventricular fusion beats 2 VEBs 1 Bigeminal 0.5 Uniform 0.5 Comment: The interesting question is whether the atrial deflections following VEBs are blocked sinus P waves or retrog