McGill Case 246

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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 example of time dependent capture. Note the the venticular pacemaker captures for several beats but then fails to capture. Capture is restored when the pacer spike falls near to a conducted sinus beat. The underlying rhythm shows a lengthening of the pr interval before a p wave fails to conduct. This suggests a Mobitz I A/V block.