dr spaceman

[dr spaceman @drspaceman96]

@ecgandrhythmRoe P-R is constant in the first 4 beats, so i dont think its Mobitz 1. The skipped beat coincides with a lengthening of the P-P interval, so my best guess is a transient, vagally mediated AV-block. The P-R on beat 5 looks too short to be a genuine conducted beat: junctional escape?

[dr spaceman @drspaceman96]

@ecgandrhythmRoe Like this, with alternating 1:2 and 1:4 conduction

[dr spaceman @drspaceman96]

@ecgandrhythmRoe I dont understand, just didnt feel random enough! Dont have calipers atm but atrial activity looks regular at 6mm, P-Q is consistently either 1.3 or 2.6mm, and R-R alternates between 17 & 19mm. I thought AFL, attributing irregular R-R and P-Q to AVB mobitz 1. Care to explain? 🙏

[dr spaceman @drspaceman96]

@ardasani @Sheshbazzar @EcgsOnly Yeah they're the same thing, personal preference :)

[dr spaceman @drspaceman96]

@EcgOxford @smithECGBlog @SwissHeartDoc @ecgandrhythmRoe @ECGEPSCADEVICE @DrRazi4 @EM_RESUS @BrooksWalsh @PendellM @The_Nanashi_O @Jagdish26039718 @ecgrhythms @PMcardioBot @RobertHermanMD Hubristic to say the least to think one can draw any meaningful conclusion about the effectiveness of primary vs delayed PCI based on "clinical experience"

[dr spaceman @drspaceman96]

@ardasani @mizcandice @Sheshbazzar @EcgsOnly Small, transient PQ-variance can occur due to respiration among other things. Were it Mobitz 1 one would expect a pattern of consistent, incremental increase in PQ before and after the skipped beat which is absent as far as i can tell

[dr spaceman @drspaceman96]

@ardasani @mizcandice @Sheshbazzar @EcgsOnly Mobitz 2 would solve both your problems i reckon :)

[dr spaceman @drspaceman96]

@ecgandrhythmRoe @TSM_Humanist @MusaMayayise @anais_dahoumane @capuzzi_luciano LPF-VT. Although typical RBBB + LAFB morphology in V1, the positive aVR, large S in V6 and QRS being relatively narrow puts me in favor of VT. Pretty sure there's AV dissociation too (see I and V3). Capture beat on the last complex seals the deal for me.