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It's the ECG's that george rejects that makes George's ECG's the best.
AIVR: False Asystole
Report: Sinus rhythm SVEBs Runs of accelerated idioventricular rhythm (AIVR) AV dissociation Ventricular fusion Comment: The AIVR takes over during slowing of the sinus mechanism following SVEBs in the middle and bottom strips and (perhaps) irregular
AV Dissociation in VT
Report: Sinus tachycardia 127/min Left atrial abnormality (LAA) First degree AV block (PR 0.22”) Axis -100o (Northwest, no-man’s land, “nonsense” axis) Probable left anterior hemiblock Right bundle branch block VEB, probably fusion beat (5th in V1)
Contrast-Induced Ventricular Fibrillation
Report: Sinus rhythm Sinus tachycardia VEBs Ventricular fibrillation Comment: It is surprising that this complication does not happen more often. The incidence was 0.75% in Gensini’s large series125, but may be larger in less experienced hands. The
VEB: the Compensatory Pause
Report:Sinus rhythm 62/min First degree AV block (PR 0.22”) VEB Left bundle branch block Comment:The P waves are sharply etched in V1 and the one blocked by the VEB is seen quite clearly. There is no need to measure the compensatory pause containing i
A Unique LBBB Aberrancy
Report: Probable supraventricular tachycardia 182/min Right axis deviation +110o LBBB Comment: The QRS complexes in V1-2 take almost 0.08” to reach the nadir of their S waves, but this is not immediately obvious on inspection. The initial QRS in V1 is
Small Ectopics
Report:Sinus rhythm. VEBs. Junctional escape beats. AV dissociation. Retrograde conduction (of VEBs). Comment:The small complexes are probably VEBs, although aberrant junctional beats cannot be excluded. A 12-lead ECG would help. Note the mirror-imag
Interpolated VEBs & Couplets
Report:Sinus rhythm VEBs, some interpolated, some (bottom strip) in couplets (pairs) Comment:In the top strip, the first VEB blocks the ensuing sinus P wave, creating a fully compensatory pause. The other two penetrate the AV junction retrogradely (conc
Ventricular Tachycardia: RV1
Report:Ventricular tachycardia 220/min. Comment:The patient's age and the relatively fast rate must have influenced the first choice of aberrancy in the Casualty report. The "VT with underlying WPW", however, suggests diagnostic skills beyond electrocard
Bidirectional Ventricular Tachycardia
Report: Bidirectional ventricular tachycardia Probable digoxin toxicity Supraventricular rhythm of uncertain origin ? atrial fibrillation VEB Multiform ventricular tachycardia Comment: Despite the adverse prognosis and her age, she was discharged hom
Flecainide: From AF to Ventricular Tachycardia
Report: Atrial fibrillation with rapid ventricular response Ventricular tachycardia 214/min Respiratory artefact Comment: This is one of the best examples of proarrhythmia I have ever seen. There is something ironic in the meticulous recording of the