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It's the ECG's that george rejects that makes George's ECG's the best.
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
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
Two for the Price of One
Report: Sinus rhythm 80/min (top) & 91/min (bottom) VEBs, two couplets Fully compensatory pauses (top) Comment: Depending on the sinus rate and the timing of the VEBs, a couplet may replace one or two sinus beats; usually it replaces two, as in the bot
Reentry (Echo) Beats of Ventricular Origin
Report: Sinus rhythm VEBs Bigeminal Couplets & triplets Retrograde VA conduction First degree VA block Wenckebach conduction Reentry Post-ectopic sino-atrial depression Junctional escape beats Comment: There are two reentry beats: third last in
VEBs: (Con)fusion Bigeminy
Report: Sinus rhythm VEBs, late-diastolic, in bigeminy Ventricular fusion beats Comment: There are, depending on the VEBs’ timing, different degrees of fusion. Note how the sinus contribution is proportional to the PR interval of the fusion beat: the
VEBs: Couplets & Concealed Retrograde Conduction
Report: Sinus rhythm Left atrial abnormality (LAA) PR interval 0.20” Intraventricular conduction delay (QRS 0.12”) VEBs in couplets Triplet (or more, end of bottom strip) of ventricular tachycardia 102/min Concealed retrograde conduction Comment:
Complex Trigeminy: Quadrigeminy in Disguise
Report: Sinus rhythm 73/min VEB couplets in trigeminy Ventricular fusion beats (second in each couplet) Concealed retrograde conduction Comment: The first VEB is interpolated between the preceding sinus beat and a fusion beat; hence the fusion beats h
Runs of Ventricular Tachycardia
Report:Sinus rhythm 85/min VEBs, couplets Runs of ventricular tachycardia 164/min Left atrial abnormality (LAA) Left bundle branch block V2-V3 lead reversal Comment:The patient had many brief runs of VT, always introduced by the qR VEB couplets. The