Friday, April 29, 2016

Supraventricular Tachycardia

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.  

Wednesday, April 27, 2016

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

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.  

Tuesday, April 26, 2016

Sinus Rhythm with Ventricular Escape Beats

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.  

Monday, April 25, 2016

Multiple and Consecutive PACs with Junctional Escape Beats

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. 

Thursday, April 21, 2016

Sinus Bradycardia with Sinus Arrhythmia

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.  

Tuesday, April 19, 2016

2nd Degree Heart Block Type II

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

Monday, April 18, 2016

Failure to Sense

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

Friday, April 15, 2016

Nonconducted PACs or Sinus arrhythmia

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. 

Thursday, April 14, 2016

Demand Ventricular Pacing.

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

Tuesday, April 12, 2016

Bigeminal PVCs

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

Monday, April 11, 2016

Friday, April 8, 2016

Atrial Flutter

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.  

Thursday, April 7, 2016


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

Wednesday, April 6, 2016

Atrial fibrillation with Wide QRS complexes

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

Tuesday, April 5, 2016


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.  

Monday, April 4, 2016

First Degree Block

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.  

Friday, April 1, 2016

Atrial Fibrillaion

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