This ECG shows Brady-Tachy syndrome, a term that has been used to describe patients with sick sinus syndrome who have both tachyarrhythmias and bradyarrhythmias.
In Brady-Tachy syndrome, bradycardia episodes are interspersed with paroxysms
of tachycardia (usually AF, atrial flutter, or some
type of PSVT). Sometimes the bradycardia occurs
immediately after spontaneous termination of
the tachycardia. An important subset includes
patients with paroxysmal AF have marked sinus
bradycardia and even sinus arrest after spontaneous conversion of AF.
ECG Flowchart
1st Degree AV Block
2nd degree AV Block Mobitz type 1 (Wenckebach Phenomenon)
2nd degree AV Block (Mobitz Type 2)
ECG : Right Bundle Branch Block
- Broad QRS complexes of more than 0.12s duration - rSR or 'M'-shaped pattern, with a small initial r wave & large secondary R wave, is seen in the right-facing chest leads V1, V2 ± V3, as right ventricular forces occur late and unopposed by left ventricular contraction; this is also manifested by late deep slurred S waves appearing in V4 to V6.
- Right bundle branch block may be a normal finding, but the change from normal conduction to one or other of these patterns implies heart disease
Left Bundle Branch Block
Today's ECG : Paroxysmal SVT – AV nodal re-entry tachycardia
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