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EP Quizzes
Question 1:
Based on this ECG strip, what does this ECG show?
1. Electrode problem or lead change
2. Ventricular standstill (phase-4 block)
3. Sick Sinus Syndrome (SSS)
4. None of the above
Question 2:
Based on this ECG strip, what does this ECG show?
1. Run of VT
2. Pacemaker
3. AIVR with fusion beats
4. None of the above
Question 3:
Based on this 12-lead ECG, what does it show?
1. Sino-atrial Wenckebach
2. Atrial bigeminy
3. Atrial trigeminy
4. None of the above
Question 4:
Based on this 12-lead ECG, what does it show?
Answer to Question #1:
This ECG rhythm strip shows ventricular standstill initiated by a non-conducted atrial premature beat. This is often known as ‘phase 4 block,’ or paroxysmal AV block, and was initiated by a non-conducted atrial premature beat.
Answer to Question #2:
This ECG rhythm strip shows sinus rhythm transitioning into a slightly faster accelerated idioventricular rhythm (AIVR). There appear to be at least 9 consecutive ventricular fusion beats of increasing progression. The P-R interval is foreshortening as the QRS complex gets wider. The differential diagnosis would be the so-called “concertina” effect in patients with WPW syndrome, where there is progressively increasing ventricular preexcitation. In such cases, the QRS complex would get wider at the expense of the P-R interval shortening.
Answer to Question #3:
This 12-lead ECG shows that every third beat is an atrial premature beat, so this is so-called atrial “trigeminy.”
Answer to Question #4:
This is piggyback heart transplant.