McGill Case 141

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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.

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This is an interesting case of bigemini. The pacemaker is an atrial pacer set at 30/min. Note the marker channel documenting (labels should be AP and AS) atrial pacing and then sensing of the QRS in the refractory period of the pacemaker. The tracing is curious as the paced atrial beats seem to stimulate a normal sinus beat and hence create the bigeminal rhythm.