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It's the ECG's that george rejects that makes George's ECG's the best.
Paced Escape - Paced Capture Bigeminy
Report:Sinus rhythm 57/min 0.5 Complete AV dissociation 0.5 Fixed pacemaker rhythm 31/min 3 Demand pacemaker escape rhythm (set at) 60/min 3 Escape-capture bigeminy 3 Comment:The original pacemaker continued to fire at 31/min as before, obviously dev
Misleading Leads
Report: Sinus rhythm 1 Left atrial abnormality (LAA) 1 LVH with ST/T changes (incomplete left bundle branch block) 2 Electronic pacemaker, probably atrium-sensing; failure to pace 5 Unusual (bamboo) spike morphology 1 Comment: The distance between th
Un Unusual Morphology
Report:Sequential AV pacemaker (known ICD) rhythm 59/min 2 Composite (? Fusion) QRS morphology 8 Comment: The ventricular complexes start as expected, with an initial slur of myocardial activation lasting approximately 0.08”. The second half of each co
Pacing Illusion
Report:Sinus rhythm 1 First degree AV block (PR 0.28”) 2 Atrial-sensing pacemaker – no captures 5 Incomplete LBBB (LVH with ST/T changes) 2 Comment:The illusion of pacing is, of course, supported by the patient’s native incomplete LBBB and its left ax
Controlling the Ventricular Rate: PVARP
Report:Atrial tachycardia 222/min (? slow flutter) with 2:1 block 4 LVH with ST/T changes (incomplete LBBB) 1 Atrial-sensing electronic pacemaker firing 111/min 1 Pseudofusion beats 4 Comment:The atrial tachycardia is somewhat discreet, but two atrial
DDD Pacemaker: Fractured Ventricular Lead
Report:Dual AV pacing 99/min 1 No ventricular capture, atrial 100% pacing 7 Right bundle branch block 2 Comment:The patient arrived to Casualty in sinus rhythm with sinus pauses and both escape and premature SVEBs (Fig 114a). He still had the SSS. The
Controlling the Ventricular Rate: Upper Rate Limit
Report: Atrial fibrillation 5 Paced ventricular response 115 – 119/min 5 Comment:The unit is pacing quite close to its upper rate limit of 120/min, obviously in response to atrial fibrillation (hence no atrial pacemaker activity – it remains suppressed
Paced Bigeminy in PAT with Block
Report:Atrial tachycardia 146/min with block 2 100% paced atrial-sensing ventricular rhythm 97/min 3 Escape-capture bigeminy 5 Comment:This is a visually striking trace, with regular atrial tachycardia resulting in bigeminal paced ventricular rhythm. T
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
Agonal Rhythm
Report:Pacemaker rhythm 60/min 2 Absolute small voltage 3 Probable acute anterior infarction 5 Comment:There is probably an atrial standstill. The patient sustained clinical acute infarction and cardiogenic shock, dying within minutes of this trace b