Here is this weeks EKG!  Post your reading and your plan in the comments.  I’ll post the answer next week!

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nchristopher

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5 Comments

doty · August 10, 2012 at 7:47 am

Very interesting. The QRS morphology is interesting. It reminds me of something I read recently…..I just can’t put my finger on it. It looks similar but just a little different.

Ian deSouza · August 10, 2012 at 12:51 pm

What was the clinical presentation?

mritchie · August 10, 2012 at 4:30 pm

She presented with episodes of palpitations for months on and off. No other symptoms.

Ian deSouza · August 12, 2012 at 6:07 pm

Ectopic atrial tachycardia with 2:1 conduction (and 1st degree AV block).

Nodal blockade for presentations which involve rapid ventricular rates. EP study with ablation for definitive management….

bberzon · August 15, 2012 at 2:50 pm

Dr.deSouza,
It seems like the 2 P’s are of different (minor) morphology. In fact it seems like the P right after the qrs is a retrograde P originating from the ventricle. Could it be that there is a loop/accessory pathway and that that is the cause of the occasional sensations of palpitations? doesn’t change the fact that she needs EP study and ablation.
Thanks Baruch

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