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It's the ECG's that george rejects that makes George's ECG's the best.
Old and New Inferior Infarction
Report:Sinus bradycardia 44/min First degree AV block Right bundle branch block Acute inferior infarction Comment:The splayed, low-amplitude P waves are difficult to time with respect to possible 2:1 block at 88/min. Even isorhythmic AV dissociation c
Paced Tricuspid Atresia
Report:Atrial pacemaker rhythm 111/min Left axis deviation –60o Left ventricular hypertrophy with ST/T changes Comment:The child had Fontan repair119 (atriopulmonary connection) in infancy. His combination of LVH and LAD is characteristic of tricuspi
Isoelectric Lead 1
Report: Sinus rhythm Third degree AV block Pacemaker rhythm Reversed arms/legs leads! Comment: Flat Lead 1 is virtually pathognomonic of legs/arms reversal. The P waves also assume retrograde polarity (one is seen in the last cycle in leads 1, 2, 3).
Sluggish Performance of Fat Complexes
Report: Atrial fibrillation with controlled response (top & bottom) Mean BP 85 & 83 mmHg Pacemaker rhythm (middle) Mean BP 68 mmHg Comment: The slight asynchrony in contraction secondary to LBBB-type conduction becomes significant in a critically imp
Complete Chest Lead Reversal
Report:Atrial pacemaker rhythm 78/min Complete chest lead reversal Possible left ventricular hypertrophy Comment:This is a rare variant of lead reversal. It happens when the entire block of V-lead terminals is rotated 180o and inserted into the machine
Physiological Pacing
Report: Pacemaker rhythm 70/min 7 AV sequential pacemaker 2 100% capture 1 Comment: The patient had a DDD (“universal”) pacemaker, now the commonest type implanted1. In this example, both the atria and the ventricles are paced, mimicking the natural s
Alternating Paced and Fusion Beats
Report:Slow atrial or junctional rhythm 38/min 2 Ventricular pacemaker rhythm 79/min 2 Superior electrode placement 2 Fusion in alternate beats 2 Presumptive RBBB 1 ST/T changes of uncertain significance 1 Comment:The narrower (0.12 sec) complexes a
Sinus Captures with 1o AV Block
Report:Sinus rhythm approx. 86/min 1 Second degree AV block, unspecified 2 AV pacemaker rhythm 60/min 1 No atrial capture 2 Sinus captures with 1o AV block 2 Left anterior hemiblock + IVCD 1 LVH with ST/T changes 1 Comment:The space between the atr
Retrograde Wenckebach and Reentry
Report:Pacemaker rhythm 92/min 1 Retrograde Wenckebach conduction 4 Wenckebach sequences terminated by reentry (echo) beats of pacemaker origin 4 Non-specific T wave changes 1 Comment:The pacemaker is in its rate-responding mode at 92/min, with Wenck
Single Failure to Capture
Report:Sinus rhythm 63/min 2 Complete AV dissociation 4 Pacemaker rhythm 80/min 2 Single failure to pace 4 Comment:AV block cannot be accurately diagnosed here: the atrial (sinus) rate is too slow and the ventricular (pacemaker) rate too fast. Just be