Showing a number of 2.8 second nocturnal pauses and bundle branch block, this latest case begs the question: is this high degree AV block and does the patient need a pacemaker? Using 11 difference traces, Assoc Prof Harry Mond delves into the topic of Wenckebach and Non-conducted Atrial Ectopics, reminding us of the differences between termination and extension, and that atrial and ventricular ectopics terminate a Wenckebach sequence differently!

This ECG was reported as complete heart block, and at first glance it sure looks like it. But a closer examination revealed the ventricular response was irregular. In this latest case study Assoc Prof Harry Mond explains two P wave patterns that reveal the rhythm as an alternating Wenckebach AV block, along with the characteristics of the rhythm and how to make sense of them.

Reported as dual chamber pacing, this case study needed closer examination. With obvious atrial pacing, the question of ventricular pacing remained. Assoc Prof Harry Mond details the characteristics that reveal the correct diagnosis, and why this should not be confused with pacemaker malfunction.

Atrial flutter or supraventricular tachycardia with block can often give the appearance of a bidirectional tachycardia, which can be caused by many other things. In this latest case study, our Medical Director Assoc Prof Harry Mond explains how to identify the characteristics of a tachycardia by using a series of ECG tracings, as well as explaining how he reached the correct conclusion when asked whether an ECG was showing a ventricular tachycardia.

Overnight Wenckebach AV block is a common finding in young people and is usually found in the presence of sinus bradycardia/sinus slowing. In this latest edition in our clinical case studies series, we look at how to identify atypical Wenckebach AV block, and how it’s affected by timing.

Reversed Wenckebach occurs when there is sequential shortening of the PR interval, and can require a permanent pacemaker in certain instances. In this latest case study, we take a look at examples of reversed Wenckebach, and how to recognise the rare ECG finding.

All pacemaker companies have programmable algorithms to prevent ventricular pacing, but this can cause issues with Holter monitor test results. Our Medical Director, Dr Harry Mond, explains how pacemakers can confuse Holter monitor tracings, and how to correctly identify these algorithms on ECG patterns.

As a rare find Wandering Atrial Pacemaker can be mistaken for marked sinus arrhythmia with unifocal atrial ectopics. Here, we look at the tell-tale characteristics that set them apart in another interesting case study by Medical Director Dr Harry Mond.

Compensatory pauses often follow atrial ectopics, but they can cause some confusion. In his latest case study, our Medical Director Dr Harry Mond clarifies the different types of compensatory pauses that can occur, as well as the typical characteristics of each compensatory pause as they present on an ECG.