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It's the ECG's that george rejects that makes George's ECG's the best.
WPW ‘A’ in AF: Positive Concordant Precordial Pattern
Report:Atrial fibrillation with (very) rapid ventricular response. Anomalous conduction (WPW type ‘A’) Wolff-Parkinson-White Syndrome Comment:The rate approaches 300/min but is obviously irregular. The trace is pathognomonic of WPW. The positive concor
VT Cardioversion: From Bad to Worse
Report: Broad complex (QRS 0.14”) tachycardia 204/min Ventricular fibrillation (post 150 Joule DCC) Sinus bradycardia (post 300 Joule DCC) Normal sinus rhythm Comment: The synchronised countershock fell on the terminal QRS complex, well away from the
Pacemaker-Induced Reverse Wenckebach
Report:Sinus rhythm 56 – 58/min 1 Reverse Wenckebach AV conduction 5 Demand pacemaker rhythm 60/min 1 Left atrial abnormality (LAA) 1 LVH with ST/T changes/incomplete LBBB 2 Comment:This may be the first reported case of reverse Wenckebach in a 12-le
Northwest Axis of Ventricular Tachycardia
Report: Ventricular tachycardia 167/min Comment: The diagnosis of VT rests on monophasic R wave in V1, rS in V6 and the bizarre, ‘Northwest’ axis in the limb leads. In V1 there is a soupçon of rabbit ears, with the left one taller than the right. In the
Arrhythmogenic Right Ventricular Dysplasia
Report: Ventricular tachycardia 162/min Comment: The patient had dilated right atrium and ventricle, with normal, mildly hypertrophied left ventricle. The coronary arteries were also normal. In Casualty, adenosine 6 + 12 mg, verapamil 2.5 mg, then sotalo
Ventricular Tachycardia: A-V Dissociation
Report:Ventricular tachycardia 150/min A-V dissociation Comment:This is, again, a LBBB-like tachycardia with normal axis, in fact diagnosed by the computer as “LBBB”. This is obviously not the case in view of the slow and notched, laboured descent to th
Trigeminal Tachycardia: Alternate Cycle Interpolation
Report: Sinus rhythm 85/min VEBs, interpolated in alternate cycles Trigeminy Comment: The P waves are regular throughout, but the PR intervals alternate, due to interpolation of the VEBs. The LBBB pattern of the VEBs has a characteristically slurred do
Dressler Beats in VT
Report: Ventricular tachycardia 160/min Spontaneous termination Ventricular fusion beats Sinus tachycardia 120/min Comment: The fusion beat during a run of VT is known as Dressler beat12. Note how it is easier to spot fusion beats looking at their r
Torsade de Pointes?
Report: Sinus/junctional rhythm SVEBs R-on-T VEBs Runs of multiform ventricular tachycardia ? torsade de pointes Comment: The purists are probably correct in reserving the name torsade(s) de pointes for multiform VT with swinging axis and a backgrou
Upright Retrograde P Waves
Report: Ventricular tachycardia 154 - 142/min Retrograde 1:1 conduction Upright retrograde P waves? Spontaneous termination after slowing to 142/min Junctional escape complex Non-specific ST/T changes VEB Comment: The tachycardia resembles, superfi