{"id":558,"date":"2016-05-29T00:03:01","date_gmt":"2016-05-29T00:03:01","guid":{"rendered":"http:\/\/torreyekg.com\/?p=558"},"modified":"2016-05-09T00:17:37","modified_gmt":"2016-05-09T00:17:37","slug":"ekg-of-the-week-32","status":"publish","type":"post","link":"https:\/\/torreyekg.com\/index.php\/2016\/05\/29\/ekg-of-the-week-32\/","title":{"rendered":"EKG of the Week #32"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/321.png\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/321.png\" alt=\"321\" width=\"647\" height=\"350\" class=\"alignnone size-full wp-image-573\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/321.png 647w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/321-300x162.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><br \/>\n60-year-old woman with palpitations and interesting EKG.<br \/>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Answer &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\"><br \/>\n<a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/Screen-Shot-2016-05-08-at-8.12.45-PM.png\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/Screen-Shot-2016-05-08-at-8.12.45-PM.png\" alt=\"Screen Shot 2016-05-08 at 8.12.45 PM\" width=\"488\" height=\"119\" class=\"alignnone size-full wp-image-574\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/Screen-Shot-2016-05-08-at-8.12.45-PM.png 488w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/Screen-Shot-2016-05-08-at-8.12.45-PM-300x73.png 300w\" sizes=\"auto, (max-width: 488px) 100vw, 488px\" \/><\/a><br \/>\nThis is another example of Ashman\u2019s phenomenon occurring during atrial fibrillation with rapid ventricular response.  Ashman\u2019s requires an irregular pattern of QRS complexes.  Repolarization of any QRS complex is proportional to the previous R-R interval.  Therefore when a relatively long R-R is followed by short R-R the QRS ending the short interval may find a portion of the conduction system still refractory (not yet fully repolarized).  The RBBB is predictably the portion of the conducting system that is slowest to repolarize, therefore the beat following the short interval is aberrant with a RBBB morphology.  If subsequent beats occur rapidly they will also find the RBBB still refractory and continue with RBBB morphology.<br \/>\n<a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/323.png\"><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/05\/323.png\" alt=\"323\" width=\"270\" height=\"127\" class=\"alignnone size-full wp-image-575\" \/><\/a><br \/>\nV1 lead from this EKG show the RBBB morphology with wide QRS and tall R wave in V1.\n<p>Also see \u201cAshman\u2019s Phenomenon\u201d in EKG Discussion for more examples of this common rhythm finding.<\/p>\n<p><\/p><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"<p>60-year-old woman with palpitations and interesting 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-558","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\/558","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=558"}],"version-history":[{"count":2,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/558\/revisions"}],"predecessor-version":[{"id":576,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/558\/revisions\/576"}],"wp:attachment":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=558"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=558"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=558"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}