This ECG was obtained from a 45-year-old man who was experiencing palpitations and lightheadedness, which he originally attributed to anxiety. There are short, but frequent periods of ventricular tachycardia, which are self-limiting. This is called "NON-SUSTAINED VENTRICULAR TACHYCARDIA". The underlying rhythm is sinus, with a remarkably long PR interval, and at least one episode of failure of the P wave to conduct, making "second-degree AV block, Type II" a possibility. It is difficult to thoroughly evaluate the underlying rhythm because it is not seen very often in this ECG.
Long PR interval
This is a nice teaching strip of a slowing sinus bradycardia that began around 40 bpm, and is slowing. It is a good example of how the sinus node slows down - there is no abrupt change of rates, rather a change with each R-to-R interval. There is also a first-degree AV block, reflecting slowing of conduction in the AV node. The PR interval is slightly variable at .28 sec. to about .32 sec.
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