Rhythm Puzzles

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These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here with permission from the publisher, Bohn Stafleu Van Loghum.


  1. An Unexpected Narrow QRS Complex -1-
  2. An Irregular Heart Beat
  3. Syncope in an Old Lady


  1. Wide QRS Complexes in the Setting of Acute Myocardial Infarction: Good News or Bad?
  2. Just an Ordinary Flutter?
  3. Wide Complexes Intervening Regular Sinus Rhythm - 3
  4. Wide Complexes Intervening Regular Sinus Rhythm - 4
  5. The ECG of a Cardiomyopathy - 2


  1. Wide Complexes Intervening Regular Sinus Rhythm - 2
  2. Palpitations after a MAZE Procedure
  3. Abnormal Repolarization, Spot Diagnosis?
  4. An Irregular Rhythm at Older Age
  5. Palpitations all the Time
  6. Five Years of Palpitations
  7. An Abnormal ECG?


  1. Right You Are
  2. Should I be Worried?
  3. A pre-excited wide QRS complex: is that all there is?
  4. An Old Lady with Chest Pain
  5. Palpitations and Dizziness in a 65-Year-Old-Man
  6. A Narrow QRS Complex Tachycardia Sensitive to Isoptin
  7. And what about the ECG?
  8. Palpitations Again, Have a Closer Look
  9. Wide Complexes Intervening Regular Sinus Rhythm


  1. ECG puzzle: Appearances Can be Deceiving
  2. Where Do the Extras Come From?
  3. 'The Turtle and the Hare'
  4. Now You See it, Now You Don't
  5. It's Not What You Think it Is
  6. One is Enough, Two is Too Many
  7. The ECG of a (Cardio)myopathy?
  8. The Ions Have It


  1. A fainting lady with some extrasystoles
  2. Syncopated rhythm
  3. An irregular rhythm at older age
  4. I Think a Niece of Mine was Referred to a Neurologist
  5. Just One Collapse During Soccer
  6. Tachycardia Terminated by Adenosine
  7. Nightly Phenomena, Day Time Work?