Rhythm Disorders

Supraventricular Arrhythmias:

• Sinus pauses
  • From a Holter monitor
  • on termination of atrial fibrillation
• Premature atrial complexes
  • Case one
  • Case two
  • PACs in trigemini
• Atrial fibrillation
  • Atrial fibrillation in a patient with a RBBB and LAHB
  • Atrial fibrillation in an elderly man
  • A 64 year old woman with atrial fibrillation and left ventricular hypertrophy
  • A 84 year old woman
  • case three with a first EKG showing left atrial abnormality and a second with atrial fibrillation
• Supraventricular Tachycardia
  • Without block
    • A 70 year old man with supraventricular tachycardia for years. The first tracing was then while the patient was in the hospital and was recorded via telemetry. This is the initiation of spontaneous A/V nodal reentry tachycardia (AVNRT).
      The second tracing was recorded in the electrophysiology laboratory and shows the initiation of AVNRT with ventricular stimulation. Compare this to the spontaneous event.
      The third tracing was recorded in the electrophysiology laboratory and shows termination of the AVNRT with ventricular pacing.
      One way of determining if a supraventicular arrhythmia is AVNRT is to compare the depolarization sequence of the left atrium from a coronary sinus recording . The left atrium depolarizes from the area of the AV node to the distal CS both in sinus rhythm and AVNRT tachycardia.
  • With block
    • Supraventricular tachycardia with block in a woman in her fifties.
    • A 72 year old man with supraventricular tachycardia with block or slow atrial flutter.
    • Supraventricular tachycardia/flutter with increased ventricular response after IV diltiazem
    • A tracing from an 80 year old man post aortic valve replacement. The recording is from his implanted pacemaker showing an atrial tachycardia. The tracing also illustrates the magnet response of this pacemaker.
    • A 12 lead EKG from a 72 year old man with supraventricular tachycardia with 2:1 block. This patient had chest pain on walking that was probably due to 1:1 conduction of his tachycardia.
    • An elederly woman with a mitral valve replacement
• Atrial Flutter
• Nodal Rhythm:
  • Three ECGs (0ne of which is nodal rhythm ) and X-ray from a patient with syncope and chest pain.
  • Accelerated nodal rhythm
    • nodal rhythm in a woman in her fifties.
    • Accellerated nodal rhythm in a woman in her seventies.
• Wolf Parkinson White
  • WPW in a 55 year old woman
  • WPW in a 43 year old man
  • case three
  • Case four
  • Case five
  • Case six
• Other atrial rhythms
  • 54 year old man with a heart transplant: The EKG shows: Sinus rhythm with a right bundle branch block and a left anterior hemiblock. Also there is a left atrial abnormality and independent atrial activity.

Ventricular Arrhythmias:

• Premature Complexes
  • In an 87 year old man
  • Bigemini
    • PVCs in bigemini in a 75 year old woman
    • PVCs in bigemini in a 75 year old woman #2
    • bigemini in a 60 year old man
  • Interpolated PVCs in a 80 year old woman
  • A patient on the hospital ward with PVCs as well as RBBB, Left Posterior Hemiblock, criteria for LAA and RAA.
  • PVC couplets
  • PVC salvos
• Ventricular Tachycardia
  • Two EKG strips from a patient with a failing pacemaker and Torsade de Pointes ventricular tachycardia
  • An EKG from a patient in the surgical recovery room showing Torsade de Pointes ventricular tachycardia
  • From an elderly woman
  • Ventricular tachycardia an elderly woman
  • Two ECGs from a patient in an emergency room, first with ventricular tachycardia and then after a shock, sinus rhythm.
  • A 66 year old man with fast ventricular tachycardia
  • A 35 year old man with an acute inferior wall M.I. and ventricular tachycardia.
  • 12 lead recording of ventricular tachycardia with intracardiac recordings in a patient with a dual chamber pacer/defibrillator and a severe intra-ventricular conduction defect.
  • VT in 62 year old man with a previous inferior wall myocardial infarction and a history of ventricular tachycardia. This page shows his EKG and an abnormal surface average EKG.
• Ventricular Fibrillation
  • 12 lead recordings from two patients with ventricular fibrillation
• Ventricular capture beats with paced ventricular rhythm
• A patient with recurrent wide complex tachycardia
• A 70 year old woman with recurrent ventricular tachycardia and a severe intra-ventricular conduction defect.

Questions From the WEB

• Atrial fibrillation
• Premature Atrial Contractions