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It's the ECG's that george rejects that makes George's ECG's the best.
VEBs Interrupting Flutter Bigeminy
Report: Atrial flutter (tachycardia) 208/min Alternating 4:1 & 2:1 block VEBs (one premature and one escape - fusion - beat) Comment: One and a half supraventricular beats are replaced! The fusion beat counts as only half-replaced. One would also be ac
Movement Artefact
ReportSinus tachycardia 141/min Borderline left atrial abnormality (LAA) Counterclockwise rotation (early transition) Non-specific ST/T changes Movement artefact in standard leads CommentThe artefact in Lead 1 mimics a dimorphic couplet of VEBs, and
Another RVOT VT: Retrograde 1:1 Conduction
Report:Ventricular tachycardia 168/min Comment:This is a good example where conduction sequences and QRS morphology do not help in making the diagnosis. Each QRS is followed after 0.18” by a sharp upright P wave in V1 consistent with a retrograde P wave;
Pentageminy!
Report: Sinus rhythm Left atrial abnormality (LAA) VEB triplets (VT 220/min) in pentageminy Comment: An allorhythmia is a repetitive pattern of a combination of beats. Pentageminy is a fanciful and rarely – if ever – used, but descriptive, name. It cou
R-on-P Bigeminy
Report:Sinus rhythm 93/min First degree AV block (PR 0.28”) VEBs, bigeminal Early transition (counterclockwise rotation) Nonspecific ST/T changes Comment:The VEBs are easily recognised for what they are, with obvious dissociation from the preceding (
R-on-T & R-on-P at the Same Time
Report: Sinus tachycardia 124/min VEBs in bigeminy & trigeminy R-on-T phenomenon Right bundle branch block Comment: The bigeminal VEBs would be still narrower were it not for the superimposition of sinus P waves on their initial vector. The VEBs not
Good Torsade, Wrong Components
Report: Sinus tachycardia 112/min Left bundle branch block Ventricular tachycardia 118/min Ventricular fusion beats Probable 1:1 retrograde conduction Junctional escape beats (bottom) Comment: The two panels are almost identical and one has to compa
Junctional Rhythm: Fusion Trigeminy
Report: Junctional rhythm 65/min Left bundle branch block VEBs in trigeminy, late-diastolic Ventricular fusion beats Comment: The junctional focus appears protected from the VEBs; the pauses are fully compensatory. The morphology of the junctional bea
VF: R-on-T Phenomenon
Report: Top: Rhythm of uncertain origin, 57 - 67/min Intraventricular conduction delay QRS 0.20” VEB, R-on-T phenomenon Ventricular fibrillation Middle : Ventricular fibrillation DCC and CPR artefact Bottom : Idioventricular or junctional rhythm
Right Ventricular Outflow Tract Tachycardia
Report:Ventricular tachycardia 165/min Irregular Non-sustained Sinus tachycardia 125/min Comment:This is a fairly typical RVOT tachycardia, with marked right axis deviation (inferiorly directed, from the “roof” of the RV) and Rosenbaum pattern in V1 (