Patient's clinical data:
75-year-old white man who presented to the emergency department. The patient was ventricularly paced on an emergent basis and the indication was probable complete AV block with an ineffective junctional escape rhythm. I don't believe this patient survived the admission of this hospital visit.
This is the next-to-last ECG that was performed on this patient. ECGs immediately recorded, just prior to this one, were of such suboptimal quality that I've determined they aren't worthy of posting in this blog. However, you don't need to view them in order to know what non-arrhythmic feature this patient's intrinsic rhythm was showing.
It could easily be argued that if you showed this 12-lead ECG to many healthcare providers, the vast majority of them would probably interpret it as nothing more than "V-paced".
(1.) What is obviously "shining through" despite the fact this patient's rhythm is ventricularly paced?
(2.) What eponymous criteria do we use to interpret this ECG?
Jason's Blog: ECG Challenge of the Week for Sept. 23-30, 2012.
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