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It's the ECG's that george rejects that makes George's ECG's the best.
Complete AV Dissociation
Report: Pacemaker rhythm 80/min 3 Sinus rhythm, non-conducted, 85/min 3 Complete AV dissociation 3 Left atrial abnormality (LAA) 1 Comment: The paced complexes have the typical LBBB/LAD appearance, indicating pacing from the apex of the right ventricl
Agonal Rhythm: Pacemaker Failure?
Report: Agonal (chaotic) rhythm 4 Pacemaker spikes 1 Slow rate 3 Failure to pace 2 Comment: The pacemaker spikes may be slow due to inhibition by the native agonal complexes or because of the battery failure. A 12-lead ECG taken 7 months previously sh
VEBs in Bigeminy
Report: Sinus rhythm 67 – 71/min 1 Ventricular pacemaker 1 VVI mode 4 Ventricular fusion beats 2 VEBs 1 Bigeminal 0.5 Uniform 0.5 Comment: The interesting question is whether the atrial deflections following VEBs are blocked sinus P waves or retrog
Pacemaker or LBBB?
Report:Sinus rhythm 65/min 2 Atrial-sensing ventricular pacemaker 8 Comment:This seems unimpeachable, except for lead V1 having the morphology of LBBB (steep descent, slow ascent) instead of expected right ventricular paced or ectopic beat (slow descent
Agonal Pacemaker Rhythm
Report: Pacemaker rhythm 80/min 4 Broad pacemaker complexes 0.36” suggest hyperkalæmia or agonal rhythm 6 Comment: It was the latter – agonal rhythm. I rang the patient’s physician who told me the patient had by then been allowed to die, in cardiogenic
Atrial Pacemaker: Failure to Sense
Report:Sinus rhythm 89/min 1 PR interval 0.20 sec 1 Atrial demand pacemaker 3 Intermittent failure to sense 4 Right bundle branch block 1 Comment:There are three atrial pacemaker beats. All three have a very early spike, always in the same spot. Th
Pacemaker Confusion in Pseudofusion: Transposition of Great Vessels
Report: Sinus tachycardia 110/min 1 Left atrial abnormality (LAA) 1 Indeterminate abnormal axis ±194o 2 Right ventricular hypertrophy 3 Pacemaker sensing spikes (pseudofusion beats) 3 Comment: The spikes occur after the onset of the QRS complex, pr
Flutter with Failed Pacemaker
Report:Atrial flutter 250/min 2 4:1 block 1 Failed pacemaker 3 Poor R wave progression 1 Nonspecific ST/T changes 1 Comment:The intrinsic pacemaker rate is 70/min – the distance from the tip of the sensed R wave to the first pacing spike and also the
Iatrogenous 1o AV Block
Report: Sinus rhythm 62/min 1 DDD (universal) pacemaker Atrial-sensing, ventricular-pacing mode 3 Atrial under-sensing in V1-3, with atrial + ventricular paced complex 3 Long A-V interval 0.30” 3 Comment: In programming the A-V sequential pacemakers
Wobbly Atrial Lead
Report: Sinus rhythm 86/min throughout 2 First degree AV block (PR 0.28”) 2 Left atrial abnormality (LAA) 1 Pacemaker rhythm (P-sensing) 86/min 2 AV interval 0.16” 2 Probable old inferior and septal infarction 1 Comment:The atrial lead became wobbl