Right You Are
|Author(s)||T.A. Simmers, A.A.M. Wilde|
|These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.|
|The ECG can be enlarged twice by clicking on the image and it's first enlargement|
A 63-year-old female was referred to our outpatient clinic with symptoms of palpitations. These had been occurring in paroxysms since 2002, and were highly drug refractory; she had undergone numerous DC cardioversions. Her ECG in sinus rhythm is shown in figure 1, during symptoms in figure 2, with a blowup in figure 3. Her prior history provides the solution to the following questions, which you might nonetheless try to answer without additional information.
- What diagnoses could the ECG in sinus rhythm suggest?
- What is your interpretation of figure 2 (aided by figure 3)?