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Is a pacemaker needed? With P waves labeled — Isn't it now much easier to appreciate that the atrial rhythm is quite regular ( with no more than a slight sinus arrhythmia )? P utting I t A ll T ogether : The precise mechanism of today's arrhythmia is complex and difficult to determine. Is this " high -grade" AV block?
KEY Point: When most beats in an arrhythmia are regular, but some are not — the best CLUE to interpretation often resides in looking for a “ break ” in the rhythm ( such as is seen between beats #13 and 14 in Figure-2 ). This is a free download ). The presence of Group beating.
ECG data is gathered and stored on the device for download and review back at the doctor’s office after the monitoring period. Because these monitors only look at a snapshot in time, they’re most often used to determine how well medications or devices like pacemakers are working. Diagnostic capabilities.
The patient may need a pacemaker. CASE F ollow- U p: Providers in today's case recognized the above abnormalities — and promptly referred the patient to a PCI center for cardiac catheterization and potential pacemaker insertion. == L ooking C loser at Today's R hythm: The rhythm in Figure-1 has a number of complexities.
MY Thoughts on Figure-1: As always I favor the P s , Q s , 3 R Approach as an optimally time-efficient way to assess any arrhythmia, including the AV blocks ( See ECG Blog #185 ). Although there is slight variation in the P-P interval this type of ventriculophasic sinus arrhythmia is common with 2nd- and 3rd-degree AV blocks.
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