In the first of a series on the electrocardiography of cardiac pacing, Assoc Prof Mond explores the fundamentals and everything you need to know about the stimulus artefact.

Not all ECG recordings are straightforward, as illustrated by this "bizarre" ECG. In this latest edition in our clinical case studies series, our Medical Director Dr Harry Mond explains how he assessed an ECG he was asked to look at, and how eliminated incorrect solutions to the symptoms being presented.

This week we take a closer look at the AV delay by exploring the differences between the paced and sensed AV delay while focusing on the importance of the law of AV conduction.

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.

Disagreement over the use of the terms “incomplete” or “partial” right bundle branch block (RBBB) had us take a deeper look at what is established in literature as an rSr’ pattern in V1/V2 with a QRS of 100 -120 ms, and when to call normal, normal!

Handed this ECG, we were asked if it was an example of a rate adaptive pacing, which uses changes in transthoracic impedance to increase the pacemaker rate in response to physiologic demand. Assoc Prof H Mond explains how to find the correct diagnosis.

This is one that is sure to spark conversation as a topic we know little about. Assoc Prof Harry Mond suggests some may even disagree with his view, and invites you not to hesitate to make some noise!

This Holter tracings showed a number of 2.8 second nocturnal pauses. A bundle branch block is also present. So the question was asked: Is this high degree AV block and does the patient need a pacemaker?

This week Dr Harry Mond reviews the ventricular ectopic compensatory pause with a focus on full and partial pauses while teaching us a lesson on timing.