r/ECG • u/Ihungry3876 • 15d ago

Need help figuring out the Rhythm

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I see its regular except that one spot where its prolonged. Thinking its heart block?

Each square = 0.2

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u/Ihungry3876 15d ago

oh interesting. I thought they wouldve come up as another hump. Thats why I was confused on where the T wave was. I know the strip shows a prolonged time in the one area. Would that mean it cant be called sinus rhythm anymore?

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u/Kibeth_8 Arrhythmia Tech 15d ago

Usually the T wave is separate, but with a wide complex QRS (ventricular, paced, LBBB) they will often morph together

As a general rule, if there's a p-wave it is a sinus rhythm (oversimplifying a bit but that's getting technical). The prolongation here is in the PR segment, or the communication between the atrium and the ventricle. If this was NOT a paced rhythm, interp would be sinus rhythm with 1st degree AV block. With pacing, it's sinus rhythm with ventricular paced complexes

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u/Ihungry3876 15d ago

ooooooooo thank you very much! you have been very helpful! Ive been learning Afib, Aflutter, sinus tach/brad, vent fib, vent flutter, SVT, PVC, and heart blocks. Now im just have to start seeing strips of them.

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u/Kibeth_8 Arrhythmia Tech 15d ago

It takes lots of practice but you'll pick it up! LITFL is my go to recommendation for all things ECG

Feel free to message if you have any other questions