Sinus Bigeminy
Report:
Sinus rhythm 98/min (top)
Sino-atrial 3:2 Möbitz 1 exit block?[!xe "Sino-atrial exit block:bigeminy" \b!]
Bigeminy[!xe "Bigeminy:sinus" \b!]
Comment:
The differential diagnosis includes SVEBs in bigeminy (where P’ waves look different to sinus P waves in some other lead) and non-conducted SVEBs in trigeminy (where their presence may, again, be visible in some other lead). There could also exist true sinus extrasystoles; I have never seen those (or recognised them, if I did).
The sinus rhythm in the top strip has the cycle length of the short cycles in the bottom strip. This confirms SA block as the mechanism of bigeminy, although it is best to see the transition in a single strip.
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