March 5, 2017

Intermittent preexcitation, QRS alternans or intermittent AV Dissociation?

A pt s/p spine surgery. 

This is: 
a. Intermittent preexcitation
b. Intermittent AV dissociation
c. QRS alternans

Image 1 - ECG case

Answer: B. Sinus rhythm (~90 bpm) with premature junctional complexes creating intermittent AV dissociation

Image 2 - Ladder diagram



  1. This comment has been removed by the author.

  2. SUPERB tracing! For those who are interested — another rhythm strip on this same patient is equally fascinating — — Please see my Comments at that site — :)


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