Trigeminy with a Pacemaker
Report:
Sinus rhythm 90/min
AV block, undefined
AV dissociation
Pacemaker rhythm 48/min
Failure to sense
Ventricular fusion beat
VEBs, interpolated
Sinus capture beats, with first degree AV block
Comment:
The VEBs are interpolated between the LBBB-like paced beats, or between sinus captures and the paced beats. This is one variety of interpolation where no difference in cycle length is apparent between the cycles containing the VEB and the “empty” pacemaker cycles.
The sinus capture beats are only slightly early with respect to the paced rhythm. Theirs’ are the only normal QRSs in the strips. It is uncertain what the conduction would be without the paced and the ventricular ectopic beats; it is one of those “block/acceleration dissociation” situations aptly described by Marriott121. The 10th complex in the bottom strip, more slender than its counterparts, is probably a fusion beat: it is preceded by an appropriately placed P wave.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and it's records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.