A weekly ECG / EKG review blog looking at some interesting ECG's from the world of Emergency Medicine.
Rate: 60 bpmRegularity: regularP-waves: Present, A-paced @ 60 bpmPRi: ~300ms, 1:1 associationQRSd: 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 degreesQTi/QTc: normalST/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 1AVBDDx: 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.