Assoc Prof Harry Mond
February 23, 2026
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78-year old deep sea diver with symptomatic sick sinus syndrome and an implanted pacemaker, programmed DDDR with an AV delay of 400 ms.
ECG reported as abnormal pacemaker function.
What do you think?
Try to diagnose each complex and then put it together.
Pacemaker mediated rhythm (tachycardia) precipitated by a ventricular ectopic.
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.
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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