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458 bytes added ,  08:08, 6 November 2015
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[[File:Schermafbeelding 2015-11-06 om 07.49.42.png]]
[[Polls| Previous cases of the month]]
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[[File:Schermafbeelding 2015-11-06 om 07.49.50.png]]
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A 53 year old woman has had mitral and tricuspid valve repair. An ECG is recorded. No P waves are seen before QRS complexes. She has temporary atrial pacemaker leads and a recording is made from these leads (recorded as V1 in the second ECG). Now it is evident that a junctional rhythm is present with retrograde P waves. A very long PQ interval is a differential diagnosis, but less likely.
 
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