ECG of the Week - 12th November 2018 - Interpretation

This ECG is from 79 y r old female who presented following a fall at home.

Click to enlarge

Rate:

• Atrial rate ~107 bpm
• Ventricular rate 36 bpm

Rhythm:

• Regular atrial & ventricular complexes
• Complete heart block
• AV dissociation
• Atrial rate > Ventricular rate

Axis:

• Normal

Intervals:

• QRS - Normal (100ms)

Additional:

• Baseline wandering
• Superimposed P waves distort terminal QRS, ST segments and T waves

Interpretation:

• Complete heart block

What happened ?

No reversible cause was identified and the patient was admitted for an uneventful PPM insertion.

References / Further Reading

Life in the Fast Lane

• Complete Heart Block

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.