Posts

Showing posts from April, 2016

Supraventricular Tachycardia

Image
The rhythm is regular.  The rate is about 210 bpm.  No P waves are seen.  We cannot be sure whether we are seeing P waves are T waves.  

Sinus Arrest

Image

Sinus Rhythm with a Wide QRS Complex with a Run of Ventricular Tachyardia

Image
The rhythm is irregular due to the run of VT.  An upright, uniform P wave is seen before the QRS complexes. The QRS complexes are wide.  An 8 beat run of VT is seen.  During the run of VT there appear to be some dissociated P waves that follow the QRS complexes.  

Sinus Rhythm with Ventricular Escape Beats

Image
The rhythm is irregular.  An upright P wave is paired with a QRS complex.  The PR interval is prolonged. We have multifocal PVCs present. A pause follows the PVCs.  The 2nd PVC is followed by some ventricular escape beats.  

Multiple and Consecutive PACs with Junctional Escape Beats

Image
The are multiple and consecutive PACs present.  It even looks like there is a dropped PAC that follows the 1st,6th, 12th, and 13th complexes.  The 1st, 7th, 13th, and 14th complexes look like junctional escape beats. 

Sinus Rhythm with Run of Ventricular Tachycardia

Image

Sinus Bradycardia with Sinus Arrhythmia

Image
The rhythm is irregular. The difference between the longest and shortest R - R interval is grater than .12 sec. There is one P wave for every QRS complex.  The P waves are uniform and upright.  

Polymorphic VT

Image

2nd Degree Heart Block Type II

Image
Non-conducted P waves are seen after each QRS complex.  The PR interval on conducted beats have the same measurement.   

Failure to Sense

Image
Pacemaker spikes are not associated with a QRS complex or appear randomly during the cardiac cycle.  

Nonconducted PACs or Sinus arrhythmia

Image
It looks like there are dropped PACs that follow the complexes 1 - 5.  If you compare the T waves in complexes 1 - 5 with complexes 6 - 10, you can see that the T waves are flatter.   The T wave of the 5th complex looks split suggesting that there might be a dropped P wave. 

Demand Ventricular Pacing.

Image
There is also ST depression and T wave inversion in the inferior leads, II, III, aVF.  

Biventricular paced with a run of Ventricular Tachycardia

Image

Bigeminal PVCs

Image
The rhythm is irregular due to the bigeminal PVCs.  Upright P waves are present and they are paired with a QRS complex.  

AV Dissociation

Image
The PR interval gets shorter as you progress through the strip.  

Atrial Flutter

Image
The rhythm is irregular.  No P waves are seen but there are some flutter waves present.  The flutter waves that are seen best in leads II, III, and aVF.  

Aberrancy

Image
There is a significant change in the morphology of the QRS complexes.  The presence of P waves suggest that there is aberrancy present as opposed to a ventricular rhythm

Atrial fibrillation with Wide QRS complexes

Image
The rhythm is irregular.  No P waves are seen.  Some fibrillation is seen between some of the QRS complexes. The QRS complexes are wide.  

Artifact

Image
At first glance this looks like a run of ventricular tachycardia.  But if you look at the V1 lead, you can see that there are organized complexes that present.  

First Degree Block

Image
The rhythm is regular.  There is one P wave for every QRS complex.  The P waves are upright and uniform.  The PR interval is prolonged.  

Atrial Fibrillaion

Image
The underlying rhythm is atrial fibrillation.  there is also T wave inversion in the inferior leads II, III, and aVF.