This patient was seen by his primary care provider (PCP) on an outpatient basis.  The PCP decided to send her patient over to me to perform a routine ECG and establish a baseline, hince the computer's statement below of "No previous ECGs available".  I printed out the above 12-lead ECG and became slightly concerned with the rhythm I was seeing.  Consequently, I also recorded six full pages of continuous rhythm (not shown here).  I don’t ordinarily resort to doing this except on those rare

This week’s ECG is categorized under the heading:“Tracing suggestive of         ” This is a classical example of this pair of derangements.

    Do you ever feel confused by pacemaker rhythms?  You are not alone!   Pacemakers are electronic devices, and have rapidly evolved in their capabilities.  Often, we call the manufacturer's representative to come and interrogate a patient's pacemaker to determine if it is behaving as it was programmed.  Without knowing the programming of the individual pacemaker, it can be hard to evaluate the patient's rhythm.

I write a lot about teaching students at different levels.  I believe you have to teach at a level your students will understand, but also raise them up from the understanding they currently have. I am asked to teach a lot of "refresher" classes, but I always hope each student leaves with some NEW information.  My mentor, Donna Harden, often admonished me that I was "teaching at a level that was too basic".   I laughed and told her that I had a successful business preparing people to take HER classes!