Assoc Prof Harry Mond
March 12, 2025
36-year old scorpion breeder with “funny” beats in the chest when being stung.
What do you think?
Sinus rhythm, atrial trigeminy with aberration and interpolation
You all got that correct. There is a wonderland of atrial ectopy patterns, provided you keep your eyes open. Let us review some of these patterns.
Trigeminy (red highlight), but no interpolation. Ectopic P wave (red arrow).
A little more complicated.
Sinus arrest; junctional rhythm with bifascicular block and atrial bigeminy (red highlight). This is a pan-conduction defect. Because the ectopics are very premature, the effective heart rate is 30 bpm.
Sinus rhythm (red arrows) with atrial trigeminy (red highlight). A more shorter coupling interval with bigeminy is conducted with aberration (yellow highlight). Also think of long-short intervals.
Sinus rhythm (red arrows) with atrial bigeminy. There are varying coupling intervals resulting in a range of conduction patterns. Normal conduction (red highlight). Left (yellow highlight)and right (blue highlight) bundle branch block aberration.
A Wenckebach AV block sequence can also occur with atrial bigeminy.
It’s all in the timing.
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May 14, 2025
Fusion is another lesson in timing! Fusion beats are an amalgam of two competing rhythms. Both are responsible for partial depolarization of the respective chambers and depending on the contribution of each, result in progeny with similarities to one or both parents.
May 14, 2025
The ventricular ectopic compensatory pause is a lesson in timing!
