Heres another one for ya :P

TheAfterAffect

Forum Lieutenant
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After seeing the "What do you think this is" thread, It got me interested in seeing who can get this one. Its another 12 lead, take a look.
test2.png



You would probably see this in a person, Such as myself if you were called to my house. Just want to see if anyone knows it or not.
 

MedicPatrick

Forum Ride Along
6
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Sinus arrhythmia with WPW?

It's a pretty small picture for a 12-lead, it's difficult to discern details from it.
 
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fma08

Forum Asst. Chief
833
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ya, i'm seen a bit of the same, sinus arrhythmia with WPW, and i may be seeing things, but maybe a little WAP in there too?? like stated above, kinda small pic.
 

MSDeltaFlt

RRT/NRP
1,422
35
48
I think not WAP due to P's are too similar. SR with physiologic left axis, with poss WPW and poss RBBB; also early repolarization. This ECG falls under the category of "duely noted". Definitely not treatable, without any symptoms.
 

el Murpharino

Forum Captain
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Correct me if I'm wrong, but there looks to be some delta waves in there too...
 

MSDeltaFlt

RRT/NRP
1,422
35
48
That's the WPW
 

mikeylikesit

Candy Striper
906
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third line looks like a third degree block. This guy is definently on a atrial triggered ventricular pacer.
 

Ridryder911

EMS Guru
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I am sure he was or hope so to.. since there is no such critter..

R/r 911
 

mikeylikesit

Candy Striper
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oops those looked like pacer spikes for a minute last night...looked liked they connected to the base line. Rid i hope you don't mean ther in no such thing as a Atrail triggered ventricular pacer? pacer meaning pace maker.
 
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mikeylikesit

Candy Striper
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That's what concerned me. Care to explain? Or was it this kind of night?:beerchug:

Edit: What looked like pacer spikes?
4 boxes down and 13 to the right the markings looked like pacemaker spikes last night at quick glance. i just figured that it was a crappy pic.
To your second question though yes my in-laws were in last night so it was most definitely a :beerchug:night. the ATVP sometimes are associated with these types of rhythms as far as i have seen lately living in a geriatric community. so yeah that first glance i said "oh pacemaker spikes got it" hence the second post when i went back to read again.
 

Ridryder911

EMS Guru
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oops those looked like pacer spikes for a minute last night...looked liked they connected to the base line. Rid i hope you don't mean ther in no such thing as a Atrail triggered ventricular pacer? pacer meaning pace maker.

I do not see any pacer spikes, as well the rate does not drop for such an event to occur.
No there is no such thing as a atrial triggered ventricular pacer.. there is an (single chamber) atrial pacer and a ventricular pacer and a (dual chamber) sequential pacer, etc.. Each is set upon the intrinsic rate for the location of the pacer.

If it is a ventricular pacemaker it will be set off by the ventricular rate, not the atrial rate again unless it is a sequential pacer and again it is concerned about the ventricular rate.
Atrial pacemakers left favor in the mid 80's because of understanding that over 65-70% of atrial filling is natural and in reality atrial contraction is not needed to sustain an adequate ejection fraction.

Here is a link to an excellent pacemaker lecture I do for Medtronics.. I recommend all to review and learn. (one has to sign up but it is free to EMT's) .. plus a lot of information on AICD, etc.. Great learning ste...

https://wwwp.medtronic.com/mdtConnectPortal/

R/r 911
 

mikeylikesit

Candy Striper
906
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The American Heart Journal did an article about it a while back but i can't see to find it yet. here is a link that another journal did about them their true name is the atrial synchronous ventricular pacers.
mostly used for third degree heart blocks.
http://www.chestjournal.org/cgi/reprint/67/4/491.pdf
 

fma08

Forum Asst. Chief
833
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where can i find the lecture rid? it leads me to... what i guess is "my homepage" on there after i have registered.
 

Ridryder911

EMS Guru
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The American Heart Journal did an article about it a while back but i can't see to find it yet. here is a link that another journal did about them their true name is the atrial synchronous ventricular pacers.
mostly used for third degree heart blocks.
http://www.chestjournal.org/cgi/reprint/67/4/491.pdf

Those are the same as commonly known as sequential or dual chamber pacemakers...

Also for the lecture use the search for "pacemaker"..

Hopefully, after you register here is the link:
https://wwwp.medtronic.com/medtroni...ea/CorePace2_FundamentalsOfCardiacDevices.ppt

R/r 911
 

mikeylikesit

Candy Striper
906
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DBieniek

Forum Crew Member
35
1
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I aggree with the WPW, it's a really bad copy of a 12 lead, maybe if you could get another one up it may help
 

MSDeltaFlt

RRT/NRP
1,422
35
48
;) got ya, but like stated earlier from a distance the markings looked like the narrow pacer spikes...whens its late.

That's the key, bud. Like just about everybody else, I'm embarrassed to admit how many times I've fallen victim to just that.
 
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