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— Today's case is an ECG Video!
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The 3 successive lead II rhythm strips shown in Figure-1 — are from a 10-year old child with palpitations.
QUESTIONS:
- What is the rhythm?
- What to consider clinically?
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| Figure-1: Succesive rhythm strips from a 10-year old child with palpitations. |
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Below is the Video presentation of today's case (9 minutes):
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Acknowledgment: My appreciation for today's case — sent to me from an anonymous follower.
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Related ECG Blog Posts to Today’s Case:
- ECG Blog #188 — Reviews how to read and draw Laddergram (with LINKS to more than 100 laddergram cases — many with step-by-step sequential illustration).
- ECG Blog #192 — AV Dissociation by Usurpation — Default — or by AV Block?
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ADDENDUM (11/8/2025):
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The 2:30 minute ECG Video below reviews:
- The Ps,Qs,3R Approach — for systematic rhythm interpretation.
- Some additional general tips on rhythm interpretation.
ECG Media PEARL #9 (4:45 minutes) — reviews the 3 Causes of AV Dissociation — and emphasizes why AV Dissociation is not the same thing as Complete AV Block.
Thanks for posting this excellent case. I have a question. Given that in strip A, the SA and Junctional rates are identical, can this be considered isorhythamic AV disassociation or do the P waves have to occur before the QRS for it to be called Isorhythamic AV disassociation?
ReplyDeleteArman — Please take a look at ECG Blog #195 for detailed discussion of Isorhythmic AV Dissociation (https://tinyurl.com/KG-Blog-195 ).
DeleteAs to rhythm A — the atrial and junctional rates are not identical. There is a slight difference in the rates — and the atrial rate varies a bit, as does the junctional rate — and that is one of the characteristics of true isorhythmic AV dissociation (Details on ECG Blog #195). Thanks again for your comment! — :)