Sinus rhythm with multifocal PVCs and non-conducted P waves

Sinus rhythm with multifocal PVCs and non-conducted P waves.  The rhythm begins as sinus rhythm, complexes 1 - 6.  A multifocal couplet makes up complexes 7 and 8.  This is followed by a brief pause.  Next is a 4 beat run of polymorphic VT.  A P wave is seen before the first PVC of the run and in between the 10th and 11th complexes.  A nonconducted PAC follows the last complex of the run (12th complex). This is followed by a period of arrest.  Another nonconducted P wave is seen during the period of arrest.  A nonconducted PAC occurs after the 14th complex.

 

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