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It's the ECG's that george rejects that makes George's ECG's the best.
Sinus Bigeminy: Sick Sinus Syndrome
Report: Sinus rhythm 1 Bigeminy, probably due to 3:2 sinoatrial exit block 2 Demand pacemaker, bigeminal fusion beats 7 Comment:The differential diagnosis for this rhythm includes sinus extrasystoles, with post-ectopic SA depression, and atypical sinu
Triple Hæmodynamic Handicap
Report:Upper strip: Dual pacemaker rhythm 89/min 1 Ventricular pacing, no atrial capture 1 1:1 retrograde (ventriculo-atrial) conduction 1 SVEB, blocked 3 Atrial capture by the atrial lead following the SVEB 1 Lower strip: Dual pacemaker rhythm 89
R-on-T Pacing
Report:Sinus rhythm 82/min 1 Ventricular pacemaker rhythm 58/min 1 Intermittent failure to sense 3 R-on-T pacing 3 Acute or recent inferior infarction 2 Comment:The first paced beat is paced just after the apex (or nadir, depending on the lead) of t
Runaway Pacemaker
Report: Pacemaker tachycardia 180/min 5 Runaway pacemaker 5 Comment: Most modern pacemakers would have a ventricular rate-limiting mechanism to prevent this degree of tachycardia. The trace itself does not offer any clues as to the cause: all one can se
Termination of SVT: Pacemaker Escape
Report:Supraventricular tachycardia 165/min 1 Electrical alternans 2 Termination of paroxysm 0 Atrial escape beat (fusion) 2 Pacemaker escape beat 1 Sinus beat (fusion) 2 VEB (last complex) 1 Nonspecific ST/T changes, possible LVH (R2 = 15 mm) 1
Rate Hysteresis
Report:Demand pacemaker rhythm 69/min 1 Posterior electrode placement 1 Rate hysteresis 3 Sinus rhythm 53/min 1 Sinus captures 1 AV dissociation with interference 1 Right bundle branch block 1 Possible old anteroseptal infarction 1 Comment:The fou
Negative Concordant Precordial Pattern
Report: Sinus rhythm 1 Supraventricular ectopic beat 1 AV dissociation 5 Ventricular pacemaker rhythm 75/min with 100% capture 3 Comment: At first it appears that the large (therefore unipolar) pacemaker spikes track the P waves, but the latter gradu
Primary T Wave Changes
Report:Ventricular pacemaker rhythm 60/min 3 1:1 retrograde conduction 2 Primary T wave changes V1-3 5 Comment:T waves concordant with the QRS complex are no more expected in paced beats than in LBBB: their orientation is due to a myocardial factor rat
T Wave Sensing
Report:Pacemaker rhythm 60/min 1 No atrial capture 2 No apparent atrial activity 3 Paced extrasystoles at 0.48 – 0.56” coupling; bigeminy ?T wave sensing 4 Comment: One cannot be absolutely sure that there were no retrograde P waves at the time of
Controlling the Ventricular Rate: Upper Rate Limit
Report: Atrial fibrillation 5 Paced ventricular response 115 – 119/min 5 Comment:The unit is pacing quite close to its upper rate limit of 120/min, obviously in response to atrial fibrillation (hence no atrial pacemaker activity – it remains suppressed