This is referred to you because of bradycardia. What
is the cause of the bradycardia in this ecg?
Figure 1
The seemingly bradycardic episodes are due to
non-conducted premature atrial complexes or PAC's (best seen in V2 marked with
red arrows) but difficult to see in the rest of the leads. Beats #3 and #5
looked like junctional beats because the P waves looked inverted in lead II.
However, in most arrhythmias, there is a unifying explanation for the whole
behavior. In this case beats #3 and #5 are PAC's that are conducted (# 3 is
conducted normally and #5 is conducted with aberrancy). Thus, the periods of
bradycardia are due to nonconducted PAC's.
Figure 2
#409
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ReplyDeleteAn interesting ECG with very reasonable interpretation, Dr. Arnel Carmona. But I saw that the morphology of beat #5 is not typical for RBBB or LBBB aberrancy. So, Is there any possibility that beat # 5 is a VPC?
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