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It's the ECG's that george rejects that makes George's ECG's the best.
Spiky Ventricular Tachycardia
Report: Pacemaker-mediated tachycardia 118/min 10 Comment: In view of the identical complexes in the admission ECG (Fig 81a) it is hard to believe that Casualty staff thought they were treating a genuine VT with amiodarone. Not to mention the same pacing
R-on-T Pacing
Report:Sinus tachycardia 106/min 1 Fixed-rate ventricular pacemaker rhythm 58/min 2 R-on-pacing 3 Fusion beats 3 Nonspecific ST/T changes 1 Comment:If the spikes go marching through another rhythm there is no way of knowing if they are atrial or vent
Atrial Pacemaker: First Degree AV Block
Report:Atrial pacemaker rhythm 90/min 4 AV interval 0.40 sec 2 Borderline intraventricular conduction delay (QRS 0.12 sec) 1 Inferior infarction, probably old 2 Nonspecific ST/T changes 1 Comment:The pacemaker is probably in the AAI mode; there is no
Pseudo-Wenckebach in Pacemaker Rhythm
Report:Sinus tachycardia 100/min 1 Atrial-sensing ventricular pacemaker 2 Pseudo-Wenckebach periods 7 Comment:There is no acceleration of the distal chamber because the increases in AV interval are not decremental as in the “natural” Wenckebach; otherw
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
Spike Decay Masking the QRS
Report:Ventricular pacemaker rhythm 65/min 1 Possible battery depletion 2 Intermittent retrograde conduction 4 Sinus rhythm 75/min 1 Probable third degree AV block 2 Comment:The faster sinus rhythm is almost certainly subject to 3o AV block, but the
Atrial Pacemaker Captures During 2:1 AV Block
Report: Sinus rhythm 0.5 AV sequential (known DDD) pacemaker 0.5 Atrial sensing & pacing 1.0”escape interval 1 AV interval 0.30” atrial-paced beats and one conducted sinus beat 1 Failed ventricular pacing 1 Second degree AV block 2:1 alternate paced
Reversed Atrial & Ventricular Electrodes
Report: Sinus rhythm (non-conducted) 1 Pacemaker rhythm 78/min 1 Reversed A & V leads 5 Intermittent atrial captures with 1o AV block & IVCD (unspecified) 3 Comment: This was a prank by a junior colleague, in this case harmless, but interesting. The v
Establishing Pacemaker Dependence the Hard Way
Report: Sinus rhythm 1 Third degree AV block 3 Idioventricular rhythm 2 QT interval 0.86” 1 Sinus arrest 2 Pacemaker rhythm 1 Comment: The surgeon, who got rather flustered when told the heart had stopped, certainly established the diagnosis of thi
Fully Compensatory Pause: Post-Ectopic SA Depression
Report:Sinus rhythm 80/min 1 Left atrial abnormality (LAA) 2 SVEB with (fully) compensatory pause 3 Atrial-sensing ventricular pacing with 100% capture 4 Comment:The SVEB, probably of atrial origin, causes a fully compensatory pause – exactly the len