Answer DV Case 5

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DV Case 5. Click on image twice for full enlargement.


This tracing shows a pause in the heart rhythm.

  • What is the cause of it?


The pause is caused atrial premature beat (PAC). The change in the T-wave preceding the pause is caused by the PAC. This PAC is not conducted to the ventricle (The AV-junction is still refractory due to the preceding conducted beat), but this PAC depolarizes the atrium. By retrograde concealed conduction to the sinus node, the next sinus beat is blocked and thus not seen on the ECG.