Original file (3,004 × 649 pixels, file size: 711 KB, MIME type: image/jpeg)
This is a rhythm strip from a 67 year old patient with mild renal failure and hypertension. He presented himself with four episodes of syncope 30-40 days apart. All episodes happened without warning, and the patient claimed that he had neither confusion nor headaches after the episodes. Monitoring in the hospital for 3 days was unrewarding. The 12 lead EKG showed only left atrial abnormality. A surface averaged ECG was considered abnormal with a QRSD of 112ms, a RMS40 of 19.8 ms and a LAS of 38.5 ms. An invasive electrophyiology test found an HV of 55-60ms, an AH of 50ms, anterograde conduction until 170/min with block in the A/V node and no change in the QRS. Retrograde conduction was to 150/min. No ventricular tachycardia was induced with three extra stimuli. Atrial flutter was induced easily, and resulted in a ventricular rate of 145/min. It terminated spontaneously once and another time with rapid atrial pacing. The patient was release from hospital and five days of Holter monitoring revealed only a slow average heart of 66/min. The patient was equipped with a loop monitor. After 38 days of monitoring his wife found him dazed in the laundry room, pressed the record button and captured a five minute rhythm segment (4 minutes before and one minute after). The strip below is part of the five minute strip.
EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten BEng, MD.McGill
Michael Rosengarten BEng, MD.McGill
Click on a date/time to view the file as it appeared at that time.
|current||00:51, 15 February 2012||3,004 × 649 (711 KB)||DarrelC|