{"id":427,"date":"2016-01-11T17:26:47","date_gmt":"2016-01-11T17:26:47","guid":{"rendered":"http:\/\/torreyekg.com\/?p=427"},"modified":"2016-01-11T17:32:25","modified_gmt":"2016-01-11T17:32:25","slug":"ekg-of-the-week-14","status":"publish","type":"post","link":"https:\/\/torreyekg.com\/index.php\/2016\/01\/11\/ekg-of-the-week-14\/","title":{"rendered":"EKG of the Week #14"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/14.png\" rel=\"attachment wp-att-429\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-429 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/14.png\" alt=\"14\" width=\"647\" height=\"357\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/14.png 647w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/14-300x166.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><\/p>\n<p>What is the rhythm of this EKG?<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Interpretation &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\">\n<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/141.png\" rel=\"attachment wp-att-431\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-431 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/141.png\" alt=\"141\" width=\"432\" height=\"85\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/141.png 432w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/141-300x59.png 300w\" sizes=\"auto, (max-width: 432px) 100vw, 432px\" \/><\/a><\/p>\n<p>The underlying rhythm is sinus at a rate of 70\/minute. The QRS morphology of the sinus rhythm complex is LBBB (QRS \u2265 120msec, tall monophasic R in V<sub>6<\/sub>). The 4<sup>th<\/sup> and 8<sup>th<\/sup> beats in the rhythm strip above have a similar morphology to the sinus beats but are premature. Notice that the T wave following the sinus beat and before the early beat is different \u2013 deformed by a premature ectopic P wave, suggesting that these early beats are PACs.<\/p>\n<p>As a confirmation, you can demonstrate that these early beats are <strong><u>not<\/u><\/strong> AV dissociated (eg, the sinus \u201cmetronome\u201d is reset by the early ectopic P and subsequent P waves do not appear \u201con time\u201d). PACs are not fully compensated.<\/p>\n<p>PVCs are fully compensated, another way of saying that they are AV dissociated and do not disturb the sinus metronome (P waves will march through the appearance of the premature beat.)<\/p>\n<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/142.png\" rel=\"attachment wp-att-432\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-432 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/142.png\" alt=\"142\" width=\"431\" height=\"96\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/142.png 431w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/142-300x67.png 300w\" sizes=\"auto, (max-width: 431px) 100vw, 431px\" \/><\/a><\/p>\n<p>While this premature beat might look like a PAC, it is fully compensated (AV dissociated) and therefore a PVC!<\/p>\n<p><\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>What is the rhythm of this EKG?<\/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-427","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/427","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=427"}],"version-history":[{"count":3,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/427\/revisions"}],"predecessor-version":[{"id":433,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/427\/revisions\/433"}],"wp:attachment":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=427"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=427"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}