Friday, 8 February 2013

ECG of the Week - 11th February 2013

Part two of the trilogy.

This is the next ECG in the series following on from last week's ECG.

So we've started our patient on amiodarone and this happens.

Click to enlarge

1 comment:

  1. Rate: 60 bpm
    Regularity: regular
    P-waves: Present, A-paced @ 60 bpm
    PRi: ~300ms, 1:1 association
    QRSd: 140-160ms LBBB appearance (although not 100% typical, but given the extensive cardiac Hx this may be the patient's normal intraventricular conduction pattern)

    Axis: 0 degrees
    QTi/QTc: normal
    ST/T-waves: appropriately discordant, however, ST-depression in II and V4/V5 are present that may be abnormal. Otherwise nothing acutely concerning.

    Rhythm: atrial paced rhythm with 1AVB

    DDx: Very interested in the lack of V-pacing at ~200ms from the A-pace. Perhaps programmed to accept a longer delay provided the detected V-rate >60bpm. No evidence of buried V-pacing or F-waves, which supports an original diagnosis of VT.