ECG Guru - Instructor Resources - Isorhythmic A-V dissociation https://www.ecgguru.com/ecg/isorhythmic-v-dissociation en Jason's Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-jan-20-27-2013 <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/jasons-blog-ecg-challenge-week-jan-20-27-2013"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%202c%20ladder.png" width="765" height="499" alt="" /></a></div><div class="field-item odd"><a href="/blog/jasons-blog-ecg-challenge-week-jan-20-27-2013"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%202c%20follow-up.png" width="765" height="417" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p><span style="text-decoration: underline;"><strong>Patient's clinical data:</strong></span>&nbsp; This 12-lead ECG is from an adult patient of unknown age and gender (<em>at the time of posting</em>).&nbsp; Active medications included Atenolol.&nbsp; Patient's only complaints and symptoms were cramps and palpitations in the form of <em>"an occasional extra beat"</em>.&nbsp; This ECG was the patient's initial "baseline".&nbsp; Based on what the patient's primary care provider (PCP) misinterpreted in this ECG, the patient ended up having an erroneous diagnosis listed among their "active problems".&nbsp; Their computerized medical record that was never expunged of this bogus information.&nbsp; A cardiac electrophysiologist was consulted and subsequently refuted the PCP's interpretation. <br><br><span style="text-decoration: underline;"><strong>Questions:</strong></span><br>1.&nbsp; What might the patient's PCP misinterpreted this as?<br>2.&nbsp; What is the actual interpretation? <br>3.&nbsp; Is there any form or manifestation of AV block here?&nbsp; If so, what is it?<br>4.&nbsp; What is the primary disturbance of rhythm here?&nbsp; What is a secondary finding to that primary disturbance?<br><br><a href="http://www.amjmed.com/article/0002-9343%2858%2990309-7/abstract" target="_blank">http://www.amjmed.com/article/0002-9343%2858%2990309-7/abstract </a></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/224/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. 1/5</option><option value="40">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. 2/5</option><option value="60">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. 3/5</option><option value="80">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. 4/5</option><option value="100" selected="selected">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Jan. 20 - 27, 2013. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-EVl7UQS5e6S8iqRLTaqvckxuT8E7fiGnL6pa3Grx1FA" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fjasons-blog-ecg-challenge-week-jan-20-27-2013&amp;title=Jason%27s%20Blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20Jan.%2020%20-%2027%2C%202013."><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Sun, 20 Jan 2013 00:39:51 +0000 jer5150 395 at https://www.ecgguru.com https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-jan-20-27-2013#comments Jason's Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-oct-28th-nov-4th <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/jasons-blog-ecg-challenge-week-oct-28th-nov-4th"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201s%20laddergram%20copy.png" width="765" height="502" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>This is one of five consecutive serial ECGs that I performed several years ago on a patient in our Outpatient ECG Lab.&nbsp; The patient was asymptomatic and the ECG was ordered as "Routine" by the patient's Primary Care Provider (PCP).&nbsp; I deliberately "froze" the tracing on the screen and captured this image because I wanted to show a transition on the ECG.<br><br>No clinical patient data available. <br><br>What does this tracing show?&nbsp; Choose the correct answer from the list below.<br><br>(1.)&nbsp; Patient with Wolff-Parkinson-White (W-P-W) syndrome and intermittent ventricular preexcitation.&nbsp; Sinus bradycardia with maximal preexciation on the first 3 beats.&nbsp; Lesser preexcitation on the 4th beat due to the Concertina effect.&nbsp; Normal conduction on the last 3 beats.<br><br>(2.)&nbsp; Junctional escape rhythm (i.e., junctional bradycardia) with left bundle-branch block (LBBB) aberrancy dissociated from a sinus bradycardia.&nbsp; Incomplete LBBB aberrancy on the 4th beat.&nbsp; Normal conduction on the last 3 beats.<br><br>(3.)&nbsp; Idioventricular escape rhythm on the first 3 beats, presumably originating from the right ventricle (RV) and dissociated from a sinus bradycardia.&nbsp; Ventricular fusion on the 4th beat.&nbsp; Normal conduction on the last 3 beats.<br><br>(4.)&nbsp; Ventricular demand pacing (rate about 40/min) from an Implantable Cardioverter-Defibrillator (ICD) and dissociated from a sinus bradycardia on the first 3 beats.&nbsp; Paced fusion on the 4th beat.&nbsp; Normal conduction on the last 3 beats.&nbsp; <br><br>(5.)&nbsp; None of the above.<br><br>HAVING TROUBLE ACCURATELY MEASURING THE DURATION OF INTERVALS, CALCULATING RATES, AND MARCHING OUT WAVEFORMS?&nbsp; NEED A PAIR OF CALIPERS TO ASSIST YOU?&nbsp; CLICK ON EITHER (OR BOTH) OF THIS LINKS TO START THE DOWNLOADING PROCESS.<br><br><span class="userContent">FREE DOWNLOADS: ICONICO ECG SCREEN CALIPERS<br> (1.) <a href="http://fileforum.betanews.com/sendfile/970815244/1/1349998026.4c01f1f8f227433ec0a215146a507710ddf22096/Calipers.zip" rel="nofollow nofollow" target="_blank"><span>http://fileforum.betanews.com/</span><span>sendfile/970815244/1/</span><span>1349998026.4c01f1f8f227433ec0a2</span><span>15146a507710ddf22096/</span>Calipers.zip</a> <br> (2.) <a href="http://www.abim.org/download/CaliperPearsonVue.exe" rel="nofollow nofollow" target="_blank"><span>http://www.abim.org/download/</span>CaliperPearsonVue.exe</a> </span></p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/224/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. 1/5</option><option value="40">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. 2/5</option><option value="60">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. 3/5</option><option value="80">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. 4/5</option><option value="100">Give Jason&amp;#039;s Blog: ECG Challenge of the Week for Oct. 28th - Nov. 4th. 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-31yWM58o6IyJL4a3rQ-ZkHBkNvO3mGTCaGCoTjld2LI" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fjasons-blog-ecg-challenge-week-oct-28th-nov-4th&amp;title=Jason%27s%20Blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20Oct.%2028th%20-%20Nov.%204th."><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Sat, 27 Oct 2012 18:41:39 +0000 jer5150 357 at https://www.ecgguru.com https://www.ecgguru.com/blog/jasons-blog-ecg-challenge-week-oct-28th-nov-4th#comments