Submitted by Dr A Röschl on Tue, 07/30/2024 - 03:26
The ECG shows an example of a patient with bradycardia/tachycardia syndrome (also called sick sinus syndrome). Initially, a sinus rhythm with a heart rate of approx. 70 bpm is seen. This is followed by sinus arrest of just under 3000 ms, followed by a junctional escape beat (no preceding P wave, QRS remains narrow). After a further pause of just under 2000 ms, 2 sinus node beats follow, which merge into a sinus tachycardia or atrial tachycardia (heart rate approx. 120 bpm here).
Submitted by Dr A Röschl on Wed, 12/20/2023 - 09:24
In this tracing, we see the limb leads + V1/V2. The first two beats are sinus node beats, there is a sinus bradycardia with approx. 55 bpm. Then there is a sinus arrest with a pause of 3000 ms, which is interrupted by a junctional escape beat. After this, the sinus bradycardia is re-established.
Submitted by Dr A Röschl on Tue, 08/29/2023 - 00:31
This EKG shows the classic features of sick sinus syndrome. Initially, there is an accelerated atrial rhythm/atrial tachycardia. After a pre-automatic pause of 2609 ms, a ventricular premature beat occurs, followed by a junctional escape rhythm. Pre-automatic pause is a pause after a tachycardia and before an automatic rhythm, like sinus rhythm or, in this case, junctional escape rhythm. Therefore, there is an alternation between tachycardic phases and very bradycardic rhythms, the classic bradycardia/tachycardia syndrome. Paper speed is 12.5 mm/sec.
Submitted by Dr A Röschl on Thu, 08/03/2023 - 01:37
Why does this EKG indicate a sick sinus node? First, we observe a sinus rhythm with a rate just below 60 bpm. Then, there is a pause of approximately 3000 ms, followed not by a sinus beat, but by a junctional escape beat (retrograde/inverted P-wave immediately after the QRS complex). This ECG was recorded at the general practitioner's office, and it can be assumed that no vagal stimulus contributed to the arrhythmia.
