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Premature ventricular contraction

ECG Basics: Sinus Rhythm With Ventricular Bigeminy

Tue, 07/07/2015 - 15:03 -- Dawn

This rhythm strip offers two leads taken at the same time, Lead II and Lead V1.  The Lead II strip may not look "typical" to a beginning student, because the sinus beats are very small and biphasic.  This is due to an axis shift, which cannot be evaluated without more leads.

ECG Basics: Normal Sinus Rhythm With Premature Ventricular Contractions

Sat, 02/21/2015 - 17:22 -- Dawn

This ECG shows an underlying rhythm of normal sinus rhythm at a rate of 80 / min.  There are two premature ventricular contractions (PVCs).  The sinus rhythm actually continues uninterrupted, causing a “compensatory pause”.  If you march out the P waves, you may even see hints of the hidden P waves in the ST segments of the PVCs.  The P waves that occur in the ST segments of the PVCs land in the refractory period of the ventricles, and so are unable to continue into the ventricles and cause a QRS.

Left Bundle Branch Block With Left Atrial Enlargement

Sun, 06/08/2014 - 22:29 -- Dawn

This ECG, kindly donated by Dr. Ahmed from India, is from a 70-year-old man shows a sinus rhythm at 80 bpm with left bundle branch block (LBBB), left atrial enlargement (LAE), and a premature ventricular contraction (PVC). The ECG criteria for LBBB is:  1) Wide QRS  - greater than or equal to .12 seconds;  2) Supraventricular rhythm;  3) QRS that is negative in V1 and positive in Leads I and V6. In leads with a positive QRS, we will see some ST depression, and in leads with a negative QRS, some ST elevation.

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