I would like your opinion about a funky EKG

[pmedic623]

Treat your pt not your machine! LOL :D/ Sorry I had to.......

[akroeze]

Is that a P wave before the second to last QRS?

[EMS49393]

Did you obtain a 12 or 15-lead ECG?

[EMT6388]

We are a smaller rural service we don't have 12 lead capabilities. We only do 3 leads

[Thunderchild145]

I'd say Atrial Fib w/PVCs. The cardio nurse here agrees with me.

[EMS Guru]

I'd say Atrial Fib w/PVCs. The cardio nurse here agrees with me.

I completely disagree with that interpretation. I would say looks like a fast sinus tach or perhaps SVT(I see P waves here and there) converting to a Junctional Rhythm with bigeminal PJCs.

[Guest CHP medic]

I'm thinking A-fib w/PVC's also, just cant be sure those are P waves on the first few complex's. Anyway I'm sure I'll change my mind if I keep looking at it.

[medic5587]

I would be interested in hearing what the patients is taking for meds, Is the patient on digitox. I don't feel it is clear enough picture to call this anymore than psvt with proximal bigemeny premature complexes.

[Thunderchild145]

Those *might* be P waves. I just keep looking and thinking A-Fib though because it's all over the place. If they are P waves then there is certainly a bit of P/QRS dissassociation in the later rhythem.

[hammerpcp]

I'm going to take a stab at this one. a larger sample would be helpful though.

the first six beats seem to have p waves of two or three different morphologies. then possibly a missed beat: firing of the atria with no capture. or artifact. but then, oh, then the atria ,or junctional there is no a clear p wave, fire again with capture. then PAC. then wait for it... wait for it.... bam! the atria fire and there is capture. PAC. what was i doing again? oh yeah.. Fire! from the atria with capture. PAC with different morphology.

QRS complexes are all narrow. wandering isoimetric line.

it looks like ST depression as well. chest pain? Hx MI?

I'm going to go with sick sinus syndrome, and i refuse to be more specific then that.