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This is a recording from an older man in the surgical intensive care unit. He was recovering from a motor vehicle accident where he sustained a chest injury from his seat belt. This recording was done after the administration of adenosine intravenously. This is an interesting cardiogram that shows the termination of a wide complex tachycardia with adenosine. The axis of the EKG is rightward and the QRS is wide at 130ms. Termination with adenosine suggests that this is a supraventricular arrhythmia that is reentrant. Note that the tacycardia slows before it terminates. The termination of the tachycardia is followed by a sinus node arrest and multiple ventricular escape beats. The first pair of beats after the termination of the tachycardia are probably an escape ventricular beat followed by a single echo beat. The second to last beat to the right is the only clear sinus beat.
This patient had a bifasicular block in sinus rhythm.
EKG World Encyclopedia http://cme.med.mcgill.ca/php/index.php , courtesy of Michael Rosengarten BEng, MD.McGill
Michael Rosengarten BEng, MD.McGill
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|current||10:51, 21 February 2012||3,004 × 1,599 (4.47 MB)||DarrelC|
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