A paced rhythm with a pacing lead in the apex of the right ventricle typically shows LBBB morphology rhythm may be paced before I decide the patient is showing frequent PVCs or a run of slow VT. Conversely, it would be very unusual for LBBB or paced rhythm to show LBBB morphology in lead V1 with That in turn further supports the dx of VT in a patient who happens to have a pacemaker. That helped me identify a run of VT at a rate of 140 when others called it a “runaway pacemaker.”

Hence, you can use leads I and aVF to place the heart’s electrical axis into one of the four quadrants Paced rhythms in particular should have a left axis deviation if the pacing lead is in the apex of the

Pacing Clin Electrophysiol. 40; 1234-1241. Smith, S. W., et al. (2018).

I initially suspected V2 as being placed too high on the chest, but there is no accompanying inverted It’s important to stress the presence of a normal QRS (i.e., no gross evidence of LVH, LBBB, WPW, or Pacemaker Again, emphasis is placed on the fact that this ECG is not grossly imperiled by abnormal depolarization

This occurred in a public place, so bystanders rushed to his aid and provided immediate assistance to He received a permanent pacemaker during the subsequent inpatient stay.

As my colleague was placing the IV catheter the patient leaned forward with Levine sign and expressed We must face the difficult reality that 30-60% LAD occlusion often does not present with clear reciprocal When faced with such a vexing circumstance – that is, an ECG that might be LAD occlusion while masquerading

manifestation had any decision making influence during ED admission. deWinter continues to rear its ugly face

The purpose here is to detail the patterns which, I believe, tend to “leap off” the page. Granted, neither possesses a HATW; but it does seem odd, and equally out of place, given the principle

This case was originally posted to the EKG Club Facebook page, and Dr.

congestive heart failure, and cardiogenic shock”—the typical grab-bag of “major adverse cardiac events” (MACE