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It's the ECG's that george rejects that makes George's ECG's the best.
Low-Atrial Pacemaker
Report:Atrial pacemaker rhythm 70/min 2 Retrograde P wave pattern 7 Nonspecific T wave changes 1 Comment:At first I thought the electrode had been inserted into the coronary sinus. It turned out the heart had been paced more conventionally through the
R-on-T Pacing
Report:Sinus tachycardia 106/min 1 Fixed-rate ventricular pacemaker rhythm 58/min 2 R-on-pacing 3 Fusion beats 3 Nonspecific ST/T changes 1 Comment:If the spikes go marching through another rhythm there is no way of knowing if they are atrial or vent
AV Dissociation with Interference
Report:Sinus rhythm 1 Borderline right atrial abnormality (RAA) 1 SVEB 1 Ventricular demand pacemaker rhythm 72/min 2 AV dissociation with interference 2 Fusion beat 2 Nonspecific ST/T changes 1 Comment:The sinus P waves march through the first fo
Atrial Pacemaker: Failure to Sense
Report:Sinus rhythm 80/min 1 Atrial pacemaker 2 Failure to sense 2 Blocked atrial P waves of pacemaker origin 4 Left bundle branch block 1 Comment:There is a profusion of pacemaker spikes and LBBB complexes, giving an initial impression of variable a
Sinus Bradycardia: Escape-Capture Bigeminy
Report:Sinus bradycardia 38/min 3 Ventricular pacemaker escape beats 2 Escape-capture bigeminy 4 Nonspecific ST/T changes 1 Comment:A precondition for escape-capture bigeminy is a very long effective supraventricular cycle, created in this instance by
Battery Depletion
Report: Atrial fibrillation 1 Third degree AV block 4 Pacemaker rhythm 44/min 1 Probable battery depletion 4 Comment: Most units are programmed to slow the basic rate as the battery becomes depleted; numbers vary. It is not certain, however, that batt
Pacemaker Completing the RBBB
Report:Sinus rhythm 70/min 1 Atrial pacemaker rhythm 55/min 2 Failure to sense 3 Capture beats 2 Right axis deviation +95o 1 Right bundle branch block 1 Comment:The atrial pacemaker discharges with complete regularity at 55/min, obviously heedless o
Reversed Atrial & Ventricular Electrodes
Report: Sinus rhythm (non-conducted) 1 Pacemaker rhythm 78/min 1 Reversed A & V leads 5 Intermittent atrial captures with 1o AV block & IVCD (unspecified) 3 Comment: This was a prank by a junior colleague, in this case harmless, but interesting. The v
Delectable Deductive Diagnosis of RBBB/LPHB
Report: Dual chamber pacemaker rhythm 70/min 2 Frontal plane axis –20o 2 Ventricular fusion complexes throughout 3 Probable underlying right bundle branch block with right axis deviation 3 Comment: I make no apologies for the subcontinental flavour of
Failure to Sense
Report:Atrial fibrillation 1 Ventricular pacemaker 1 Failure to sense 2 R-on-T pacing 2 Fusion beat 2 Incomplete right bundle branch block 1 Nonspecific ST/t changes 1 Comment:Failure to sense is only intermittent, since the pacemaker discharge is