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.

Assoc Prof Mond shares this case to delve into unusual and classical patterns of twisted leads in 12-lead ECG, including the double twist, and shares the tell-tale footprints of all.

Assoc Prof Harry Mond identifies a plethora of insights that come with studying Wenckebach sequences. This week, a definitely not boring look into atrioventricular (AV) and non-AV types, and how it’s all in the timing!

A controversial one this week: AFib with ventricular bigeminy. Or is it? Exploring trigeminy, ventricular parasystole, pseudo-ventricular parasystole and other possibilities, this one is sure to divide opinion.

The Holter monitor tracings of a 44-year old male caused a lot of excitement at CardioScan this week. With 12 bradycardia episodes overnight, it was initially considered Wenckebach AV block. While clinically, rather than visually, correct, it nevertheless, did not fulfil the footprints of Wenckebach and closer examination revealed asymptomatic episodes of sinus bradycardia and second-degree AV block as a result of vagal hypertonia.

This week Dr Harry Mond revisits the well-known and researched ventricular interpolation with a review of the footprints and exceptions to the rule in a bid to teach something new.

Right ventricular pacing may, over time, result in left ventricular dysfunction. This week Dr Harry Mond explores the range of minimisation algorithms developed for its management, while reviewing the law of AV conduction.

This week we had a Holter monitor recording reported as complete heart block. For obvious reasons this can be a serious diagnosis, but the reporting cardiologist felt it was Wenckebach sequences and requested a review.

Something rarely seen in Holter monitoring, the ventricular pentageminy with ventricular ectopics every 5th beat, and other curious rhythms!