Atrial Fusion Beats
Report:
Sinus rhythm
Junctional ? atrial rhythm
Shifting (atrial) pacemaker
Atrial fusion beats
AV dissociation
Probable third degree AV block
Pacemaker rhythm 63/min
Comment:
Again, this is a "trick" question, designed to make one look (in vain) for ventricular fusion beats. The fusion is confined to the atria, at the transition between the two atrial pacemakers. As Schamroth said: The obvious is obvious. Look elsewhere10.
The complete heart block is only a presumption here - it is possible that some AV conduction would occur if the ventricular pacemaker were slower or the atrial rate faster.
If you have any suggestions for or feedback on this report, please let us know.
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