Wide Complexes Intervening Regular Sinus Rhythm

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Author(s) A.A.M. Wilde
NHJ edition: 2006:12,436
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
Figure 1

A 28-year-old, wheelchair bound, female patient with Friedreich’s ataxia presents with an irregular heartbeat. She has no history of syncope or dizziness and no other complaints. Physical examination of the heart reveals no abnormalities. There are neither signs of left nor right heart failure. Her pulse is in principle regular, but occasionally some irregularities are observed. The ECG is depicted in figure 1. An echo is normal.

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