McGill Case 123

This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia. Previous Case: McGill Case 122 | Next Case: McGill Case 124

This is an electrocardiogram from a 87 year old man with a history of atrial fibrillation. His medications were coumadin and Monopril. The cardiogram shows sinus rhythm with rate of about 50/min, and a marked first degree heart block with a pr interval of about 350ms. The first complex on the left is a fusion between the patient's native QRS and the pacemaker spike (this is nomal operation) this is followed by a PVC. Note the small blip following the PVC is artifact and is not a failure to capture of the pacemaker. The pacemaker is working well as a VVI pacer set at 50/min. The large spikes suggest a unipolar lead.