This ECG is a good example of sinus rhythm with aberrantly-conducted PACs. The tracing was donated to the ECG Guru several years ago by Dr. Ahmed from Sanjiban Hospital in India. We have no patient data for this tracing.
This three-lead rhythm strip is from an 85 year-old-woman for whom we have no other information, unfortunately. It shows an obvious, regular bigeminal pattern. There are many rhythms that can cause bigeminy, with regular, paired beats. So, how do we analyze this rhythm?
This ECG is from an 88-year-old man with congestive heart failure. No other clinical information is known. It shows an underlying sinus rhythm with atrial bigeminy - every other beat is a premature atrial contraction. There is very little, if any, difference in the morphology of the sinus P waves and the ectopic P waves, indicating that the ectopic focus is in the vicinity of the sinus node. There is no "compensatory" pause, because PACs penetrate the sinus node, resetting it. So, the underlying sinus rate here is about 72 beats per minute.
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