At Dawn's request, this month's ECG is laying down the foundation for a topic she wanted me to eventually talk about on the ECG Guru. On this ECG, I'm not just looking for the obvious disturbance of rhythm. This type of ECG is literally begging for a laddergram to help reveal the mechanism responsible for a couple of very subtle and rare findings.
At this time of posting, I currently have no clinical data for this patient. This ECG is of interest because of its arrhythmic and nonarrhythmic elements.
I can think of at least two possible explanations for the mechanism of this rhythm and both would benefit from being illustrated by a laddergram.
One mechanism is rather exotic and has not been previously seen here on this website or discussed in the various FB forums.
Amongst the computer's several statements was the interpretation of "Undetermined rhythm". To the computer's statement, the reviewing cardiologist added the freehand text of "Abnormally slow" but failed to provide a diagnosis.
Patient's clinical data: 47-year-old black man. Another serial ECG (seen below) showed a supraventricular tachycardia (SVT) at a rate of 164/min that was diagnosed by an Electrophysiologist as atrioventricular nodal reentrant tachycardia (AVNRT). How does knowing the mechanism of AVNRT help you in determining the nature of the mechanism in this week's ECG.
