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TitleDescriptionSubjectCollection
176 Atrial tachycardia with 3:2 AV blockIn this rhythm the atrial rate from an ectopic focus is 160 bpm. Atrial activity can be seen on top of T waves, and before QRS's. Careful observation reveals a 3:2 Wenckebach relationship between P waves and QRS's. Atrial tachycardia with block is often a sign of digitalis intoxication.Knowledge Weavers ECG
177 Ventricular fusion beatsFusion beats occur when two or more activation fronts contribute to the electrical event. These may occur in the atria or in the ventricles. In this example the ventricular fusions are the result of simultaneous activation of the ventricles from two foci, the sinus node and a ventricular ectopic...Knowledge Weavers ECG
178 Diagram: digitalis effect on rhythm and conductionDiagram: digitalis effect on rhythm and conductionKnowledge Weavers ECG
179 Calibration signal - marquetteCalibration signal - marquetteKnowledge Weavers ECG
180 Old inferior MIOld inferior MIKnowledge Weavers ECG
181 Second degree AV block, type I, with 3:2 conduction ratioThere are two types of 2nd degree AV Block. In this example of Type I or Wenckebach AV block there are 3 P waves for every 2 QRSs; the PR interval increases until a P wave fails to conduct. This is an example of group beating.Knowledge Weavers ECG
182 Infero-posterior MI with RBBBThis is an unusual RBBB because the initial R wave is taller than the R wave in lead V1. This is the clue for true posterior MI. The tall initial R wave in V1 is a pathologic R wave analagous to the pathologic Q wave of an anterior MI.Knowledge Weavers ECG
183 Right Atrial Enlargement (RAE) & Right Ventricular Hypertrophy (RVH)RAE is recognized by the tall (>2.5mm) P waves in leads II, III, aVF. RVH is likely because of right axis deviation (+100 degrees) and the Qr (or rSR') complexes in V1-2.Knowledge Weavers ECG
184 Frontal plane: accelerated junctional rhythm and inferior MIFrontal plane: accelerated junctional rhythm and inferior MIKnowledge Weavers ECG
185 QRS axis = -30 degreesLead II is isoelectric; I is positive; III is negative. The axis is -30 degrees.Knowledge Weavers ECG
186 Voltage criteria for LVHVoltage criteria for LVHKnowledge Weavers ECG
187 Infero-posterior MIInfero-posterior MIKnowledge Weavers ECG
188 RBBB - marquetteRBBB - marquetteKnowledge Weavers ECG
189 Second degree AV block, type I, with bradycardia-dependent RBBBAn interesting and unusual form of rate-dependent bundle branch block. Normal sinus rhythm at 85 bpm is present with a 3:2 and 2:1 2nd degree AV block. The progressive PR prolongation in the 3:2 block makes this a type-I or Wenckebach block.Long cycles end in RBBB; short cycles have normal QRS dur...Knowledge Weavers ECG
190 Bifascicular block: RBBB + LAFBThis is the most common of the bifascicular blocks. RBBB is most easily recognized in the precordial leads by the rSR' in V1 and the wide S wave in V6 (i.e., terminal QRS forces oriented rightwards and anterior). LAFB is best seen in the frontal plane leads as evidenced by left axis deviation (-50...Knowledge Weavers ECG
191 Frontal plane lead diagramThe six frontal plane leads are illustrated with their respective positive and negative poles.When forced to intersect at a center point, the six leads inscribe a 360 degree circle. The normal frontal plane axis is from -30 degrees to + 90 degrees, shaded in grey. Left axis deviation is from -30 d...Knowledge Weavers ECG
192 Anteroseptal MI: fully evolvedThe QS complexes, resolving ST segment elevation and T wave inversions in V1-2 are evidence for a fully evolved anteroseptal MI. The inverted T waves in V3-5, I, aVL are also probably related to the MI.Knowledge Weavers ECG
193 Atrial parasystoleThe evenly spaced dots indicate ectopic atrial activity from a parasystolic atrial pacemaker. Non-fixed coupled PACs are seen having a common inter-ectopic interval. One of the PACs is nonconducted.Knowledge Weavers ECG
194 Ventricular tachycardia - marquetteVentricular tachycardia - marquetteKnowledge Weavers ECG
195 Long QT IintervalLong QT IntervalKnowledge Weavers ECG
196 ECG of the century - part II: dual AV pathwaysAn astute cardiology fellow, yours truly, went to the patient's bedside on Day 2 and massaged the right carotid sinus as indicated by the arrow. Four beats later at a slightly slower heart rate the PR interval suddenly normalized suggesting an abrupt change from a slow AV nodal pathway to a fast AV...Knowledge Weavers ECG
197 Left Atrial Enlargement & Nonspecific ST-T Wave AbnormalitiesLAE is best seen in V1 with a prominent negative (posterior) component measuring 1mm wide and 1mm deep. There are also diffuse nonspecific ST-T wave abnormalities which must be correlated with the patient's clinical status. Poor R wave progression in leads V1-V3, another nonspecific finding, is als...Knowledge Weavers ECG
198 Atrial flutter with 3:2 AV conductionThis 12-lead ECG shows a subtle bigeminal rhythm resulting from atrial flutter with a 3:2 AV conduction ratio; RR intervals alternate by a small duration. This is uncommon! The impulses from the atrial flutter conduct through the AV junction in a Wenckebach sequence; for every 3 flutter waves the s...Knowledge Weavers ECG
199 A very subtle 1st degree AV blockWhere are the P waves??? They are hiding in the T waves as indicated by the arrows. How do we know? The PVC unmasked the sinus P wave, and now it is seen in the pause following the PVC. The PR interval is, therefore, about 500 ms.Knowledge Weavers ECG
200 PAC's with and without aberrant conduction - marquettePAC's with and without aberrant conduction - marquetteKnowledge Weavers ECG
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