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- Mean ventricular rate ~78 bpm
- Regularly irregular
- Repeating pattern of sinus complex followed by two ventricular complexes
- Sinus complexes: Normal
- Ventricular complexes: Left axis deviation
- PR - Normal (140ms)
- QRS - Normal (80ms)
- QT - 380ms
- QRS - Prolonged (120-140ms)
- QT - 360 ms
- Minor ST elevation sinus complex in lead V6
- Ventricular complexes show appropriate ST segment and T wave discordant change
- Notching in terminal portion of ventricular QRS best seen in leads aVL and aVF ? native atrial activity - thanks to Ken for spotting this.
Benign arrhythmia which will likely resolve once the underlying bowel obstruction has resolved.
Causes could include:
- Electrolyte abnormality
- Acid/base disturbance
- High vagal tone secondary to pain and nausea
- Drug toxicity pending a review of the patient's usual medication
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.