Monday, February 29, 2016

Ventricular Paced After a Salvo of PVCSs

On this page, the patient is in sinus rhythm and has a multifocal triplet of PVCs.  Afterwards, he transitions into a ventricular paced rhythm.

Friday, February 26, 2016

Sinus Bradycardia with Ventricular Escape Beats

On this page the patient is in a sinus bradycardia.  There is a PVC after the third complex and this is followed by two ventricular escape beats.

Thursday, February 25, 2016

Failure to Capture and Loss of Arterial Pressure

This is an interesting strip.  The patient has a ventricular pacemaker for what looks to be complete heart block.  The lead V1 you can see dissociated P waves.  In lead III we can see where the pacemaker has failed to capture resulting in a period of arrest.  In the V1 lead you can see the dissociated P waves more clearly during the period of arrest.  The bottom lead is an arterial wave form and you can see the dramatic fall in the blood pressure during the episode of the loss of capture.

Wednesday, February 24, 2016

Ventricular Tachycardia

On this page the patient was having a run of VT that spontaneously converted back to atrial fibrillation.

Tuesday, February 23, 2016

NSR changing to SVT

In this page the patient is in sinus rhythm.  Then a PVC occurs on the 5th complex and it induces a run of an atrial ectopic rhythm.  The width and morphology of the QRS complexes do not change, so I think that it is supraventricular.  In leads I and II, it looks like there are some occasional P waves that look different from the sinus P waves. 

Monday, February 22, 2016

Atrial Fibrillation with a Run of VT

This a 7 lead rhythm summary that I printed from our monitor of a patient in atrial fibrillation. Hopefully you can enlarge it on your computer. The QT interval is about .44 sec.  A couplet occurs right after the T wave and induces a run of VT.  Not quite an R-on-T episode but very close.  Perhaps enough of the ventricle was still in a relative state of depolarization to induce the run of VT.