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It's the ECG's that george rejects that makes George's ECG's the best.
VEB and DDD Pacemaker
Report:Sinus rhythm 73/min 1 VEB 3 Atrial-sensing ventricular pacemaker 4 Atrial-paced beat 2 Comment:Universal (DDD) pacemakers can both sense and pace the atria. The pause created by the VEB is terminated by an atrial-paced P wave and ventricular-pa
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 Sensing & Undersensing
Report:Atrial-sensing & pacing ventricular pacemaker rhythm 60/min 3 Atrial premature beats, possibly sinus 3 Blocked or sensed with first degree AV block or not sensed 3 Atrial bigeminy 1 Comment:All the QRS complexes are paced. The morphology of t
Pacemaker-Ventricular 4:3 Block
Report: Sinus rhythm 1 Atrial-sensing ventricular pacemaker 3 Trigeminy due to 4:3 pacemaker-ventricular block 6 Comment:The paced beats show the expected RV apical pacing morphology of LBBB with LAD. The reason for the intermittent failure to pace is
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
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
Atrial Sensing and Pacing
Report:Sinus rhythm 75/min 1 VEB 1 Atrial-sensing ventricular pacemaker 3 Atrial sensing and pacing ventricular pacemaker (last beat) 4 Left atrial abnormality (LAA) 1 Comment:This is a DDD pacemaker, responding to both the atrial activity and the la
Sensing but not Pacing
Report:Sinus rhythm 100/min 2 2:1 AV block 3 Left atrial abnormality (LAA) 1 Failure to pace in atrial-sensing pacemaker 3 Prolonged QT interval 0.56” 1 Comment:The unit is almost certainly a DDD one, with preserved atrial sensing but no ventricular
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
Fat QRS Complexes
Report: Sinus rhythm 1 First degree AV block (PR 0.24”) 1 Right bundle branch block (QRS 0.20”) 2 VEBs ? junctional premature beats (QRS 0.20”, one narrower 0.12”) 1 Demand pacemaker 2 LBBB morphology (QRS 0.20”) 0 Fusion beats (narrowest QRS 0.16”,