This post is an answer to the ECG Case 207
- Rate: 42 bpm mean ventricular rate
- Rhythm:
- Irregular
- Junctional escape rhythm
- Complexes number 1, 3, 4, 5
- Rate ~ 36 bpm
- Sinus
- Complexes number 2, 6, 7
- Axis: Normal (~70 deg)
- Intervals:
- PR – Upper limit normal where present (~200ms)
- QRS – Normal (100ms)
- QT – 520ms
- Segments:
- ST Sagging in leads II,III,aVF,V5-6
- Additional:
- T wave notching in leads V1-3 in 5th complex likely secondary to lead transition
- Biphasic T wave in V1
- P waves broad & notched
Interpretation
Intermittent sinus arrest with junctional escape rhythm.
What happened ?
This ECG was captured during a symptomatic episode of presyncope. The patient then spontaneously reverted to sinus rhythm after a few minutes. His beta-blocker was ceased and he was transferred for PPM insertion.
