Friday, 2 November 2012

ECG of the Week - 5th November 2012

Another two parter for this fortnight. 

This ECG is from an 83 year old male.
Presented with chest pain, nausea, dysponea following brief episode of LOC.
Past Hx - warfarinised, previous AF / flutter / bradycardia, PPM inserted 7 years prior.

Click to enlarge

1 comment:

  1. Rate: 180bpm
    Regularity: regular
    P-waves: none noted, possible pacer spikes appreciated in aVR @ ~60 bpm.
    PRi: none
    QRSd: wide-wide @ 180ms
    Axis: ERAD (+aVR)

    Rhythm: presumed ventricular tachycardia (given the axis I'm not willing to make any other Dx)

    Pacemaker appears to be firing in VOO mode (obviously not in DDD or VVI as the ventricular arrhythmia should be inhibiting the response) due to the rate of the spikes. (If they weren't so drop-dead regular I'd write them off as artifact.)