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It's the ECG's that george rejects that makes George's ECG's the best.
VVI Pacemaker Mime of Atrial Sensing
Report:Pacemaker rhythm 70/min 4 Atrial tachycardia/flutter 210/min 6 Comment: The patient had a VVI pacemaker set at 70/min, precisely because she had almost constant atrial tachyarrhythmias. In this tracing, however, the AV interval appears fixed at
T Wave Sensing
Report:Pacemaker rhythm 60/min 1 No atrial capture 2 No apparent atrial activity 3 Paced extrasystoles at 0.48 – 0.56” coupling; bigeminy ?T wave sensing 4 Comment: One cannot be absolutely sure that there were no retrograde P waves at the time of
Sinus Bigeminy: Sick Sinus Syndrome
Report: Sinus rhythm 1 Bigeminy, probably due to 3:2 sinoatrial exit block 2 Demand pacemaker, bigeminal fusion beats 7 Comment:The differential diagnosis for this rhythm includes sinus extrasystoles, with post-ectopic SA depression, and atypical sinu
High Electrode Tip Irrelevant
Report: AV pacemaker rhythm 89/min, 100% atrial and ventricular capture 2 Positive QRS axis +25o 8 Comment: Post-CABG, the pacemaker leads are “implanted” epicardially. Thus the positive L2 does not denote difficult pacing, instability, or irritabilit
Sensing and not Sensing Atrial Fibrillation
Report:AV sequential pacemaker rhythm 60-75/min 5 Atrial fibrillation 5 Comment: For much of the trace the pacemaker is firing through both barrels, unaware that AF precludes any atrial capture. This wastes the battery. On the other hand, having a rapi
Congenital Heart Block with Long QT Interval
Report: Sinus rhythm 100 - 110/min Third degree AV block Junctional escape rhythm 48/min VEB SVEB Prolonged QT interval 0.60” QTc 0.53” Comment: This case has been reported73. While it is not possible to exclude post-syncopal QT prolongation in
Wenckebach AV Block in Marked Sinus Tachycardia
Report: Sinus tachycardia 138/min Second degree AV block, Möbitz 1 Probable acute inferior infarction Comment: It is unwise, generally, to diagnose infarction from rhythm strips, but this one has all three indicative changes of acute infarction: Q
Alternate-Beat Wenckebach Caused by VEBs
Report:Sinus rhythm 92/min VEBs, couplets and triplets R-on-T phenomenon Wenckebach second degree AV block for alternate P waves Acute or recent inferior infarction Comment:The first two consecutively conducted P waves show slight but definite PR i
Concealed Non-Conduction
Report: Atrial tachycardia 186/min 3:1 AV block Comment: Can one really tell? The descent of some T waves is sharper than expected or shallowly notched; the same cycles also have a notch immediately following the end of the preceding QRS complex. So
Adenosine Asystole
Report:Atrial flutter 300/min High-grade (advanced) second degree AV block Transient asystole Ventricular escape beat Comment:The patient was admitted to CCU in flutter 310/min with 2:1 block (Fig 12a below). In all fairness, distinction from SVT ca