A Fall and a Rhythm to Recognize

CONCLUSION: The above bullets point out too many findings to be by chance. Therefore, these consistent relationships that are highly unlikely to be by chance tell us — there must be some type of conduction going on in this irregular, long-lead rhythm strip.PEARL #2: It is sometimes very helpful to “step back” a little bit from the tracing — to gain an overall perspective of the pattern of a complex rhythm. PROVE THIS to yourself. Go BACK to my unlabeled Figure-1— and take another look at the long-lead rhythm strip. Realizing that there is some distortion from the angling in this picture — Isn ’t it now easier to appreciate the relationships I highlighted in the bullets of my previous section?Becoming comfortable recognizing group beating and other patterns of beats that repeat — provides an invaluable initial clue that can tell you within seconds that there is some type of conduction.PEARL #3: It is very common to see Wenckebach conduction in association with both AFlutter and ATach. In today ’s case — it was the combination of group beating + multiple PR and R-R intervals that are the same that strongly suggested to me that there was Wenckebach conduction, in this case out of the AV node.An important “Take-Home” point fr...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs