Reentry (Echo) Beats of Ventricular Origin

Report:

Sinus rhythm

VEBs

Bigeminal

Couplets & triplets

Retrograde VA conduction

First degree VA block

Wenckebach conduction

Reentry

Post-ectopic sino-atrial depression

Junctional escape beats

Comment:

There are two reentry beats: third last in the top strip and fourth in the bottom strip. Both are preceded by an inverted P wave with RP interval much longer than the previous RP interval. This is the usual setting for reentry to occur. The antegrade conduction time is much shorter here, at 0.14”; it may indicate separate antegrade and retrograde pathways.

The sino-atrial depression sets in with the occurrence of retrograde conduction toward the end of the top strip. Before that, the sinus P waves prevent retrograde conduction by falling on the ST segment of the VEBs.

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