Assoc Prof Harry Mond
February 23, 2026
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Figures 1 and 2 are from a normal control. The tracing is normal in 1 and the leads reversed in 2 so that the arm leads are now on the feet and the leg leads are attached to the arms. Lead I looks at the legs and not the arms and its isoelectric appearance not surprising.I see about two examples of this per month.If you don’t, then you are not looking hard enough!
Figure 3 is a comparison of the lead positions with the classical features listed below.
The ECG should be repeated as important pathology may be missed. For example, the rhythm in figure 4 puzzled us and we eventually went with a supraventricular tachycardia, despite a consistent irregularity and possible p waves in V6. The isoelectric lead I made us ask for a repeat (figure 5). The P waves now emerge and the diagnosis is sinus tachycardia and atrial ectopics
Assoc Prof Harry Mond
September 11, 2026
Fusion beats are an amalgam of two competing rhythms within the same chamber, atrial or ventricular. They are not “abnormal” beats and are a lesson in timing. For fusion beats to occur, two foci must commence propagation at or near the same time and both contribute to chamber depolarization. Both must be either atrial or ventricular and depending on the contribution of each, the resultant progeny have similarities to one or both parents.Â
August 26, 2026
Is this the impossible pacemaker ECG? It took me a while to work out what was going on. Is it pacemaker malfunction?‍ What do you think?
July 24, 2026
I came upon these ECG tracings of ventricular tachycardia from a Holter study in a 79-year old asymptomatic female. What do you think?
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