AF with Regular Response?
Report:
Atrial fibrillation
Accelerated (idio)junctional rhythm
Comment:
Verapamil is known to “regularise” the ventricular response to atrial fibrillation. Completely regular rhythm, however, implies AV block and the presence of an escape pacemaker.
In this instance, the escape pacemaker is slightly accelerated (the intrinsic junctional rate is 40-60/min), probably due to digoxin therapy.
Predictably, when the Surgeon heard the above (his Registrar was quite knowledgeable), he snapped “Get a heart doctor!” and stomped away.
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