{"id":604,"date":"2016-07-09T18:10:51","date_gmt":"2016-07-09T18:10:51","guid":{"rendered":"http:\/\/torreyekg.com\/?p=604"},"modified":"2016-07-09T18:12:17","modified_gmt":"2016-07-09T18:12:17","slug":"ekg-of-the-week-36","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2016\/07\/09\/ekg-of-the-week-36\/","title":{"rendered":"EKG of the Week #36"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/361.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-605\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/361.png\" alt=\"361\" width=\"647\" height=\"357\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/361.png 647w, http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/361-300x166.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\nWhat is the rhythm change seen on this tracing?<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Answer &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\nBaseline is sinus rhythm at 68\/minute<br \/>\nNormal axis and intervals<br \/>\nEssentially normal EKG with several strange QRS complexes\u2026<br \/>\n<a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/362.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-607\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/362.png\" alt=\"362\" width=\"432\" height=\"88\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/362.png 432w, http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/07\/362-300x61.png 300w\" sizes=\"auto, (max-width: 432px) 100vw, 432px\" \/><\/a>\n<p>First, if you march the P waves through, they remain constant (note the pen marks of some helpful person). The 4<sup>th<\/sup> and 5<sup>th<\/sup> beats in this rhythm strip are wide-complex and dissociated from the P waves. This rhythm is sometimes called \u201cslow v tach\u201d to indicate the independent (ectopic) ventricular source. This is accelerated idioventricular rhythm (AIVR).<\/p>\n<p>Another helpful feature of this ventricular rhythm are fusion beats as the rhythm phases in and out with sinus rhythm, often at a similar heart rate. In this rhythm strip, the 3<sup>rd<\/sup> and 6<sup>th<\/sup> beats are fusion beats \u2013 that is, a combination of the sinus beat and the ventricular beat.<\/p>\n<p>AIVR is well known as a repolarization arrhythmia (especially after TPA or interventional cath). It can also occur in essentially normal patients for no apparent good reason, as was the case in this otherwise healthy young woman.<\/p>\n<p><\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>What is the rhythm change seen on this tracing?<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-604","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/604","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=604"}],"version-history":[{"count":3,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/604\/revisions"}],"predecessor-version":[{"id":609,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/604\/revisions\/609"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=604"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=604"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=604"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}