tag:blogger.com,1999:blog-549949223388475481.post6789337035462655759..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: A Mystery Rhythm, Explained by K. Wang's Ladder Diagram.Unknownnoreply@blogger.comBlogger4125tag:blogger.com,1999:blog-549949223388475481.post-31293256391316529682014-09-30T09:35:59.920-05:002014-09-30T09:35:59.920-05:00I think one alternate explanation would be that P-...I think one alternate explanation would be that P-waves #1, #4, and #7 are actually further back into the T-wave than marked by Dr. Wang (the nadir). If we go to the first visible T-waves in V1 and V2, it appears that they have deformations consistent with atrial activity. Given each of the junctional complexes feature identical q-waves in II, and the P-amplitude is fairly large, I don't know that I would put them buried in the QRS. If we instead place them at the nadir of the T-wave on those beats, the P-P intervals would then decrease in duration until the jump...I'll email my proposed laddergram.<br /><br />This would lend itself towards a more exotic explanation of sinus bradycardia (~54 bpm), Type I SA Block (causing an effective slowing of the sinus rate to the mid-40s), a junctional escape rhythm (~50 bpm), and occasional capture beats.Christopherhttps://www.blogger.com/profile/11415988855392944633noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-14068514628190735832014-09-29T09:34:29.334-05:002014-09-29T09:34:29.334-05:00Very nice. Do You think Valsalva could help ?Very nice. Do You think Valsalva could help ?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-6531366523525396252014-09-27T03:34:38.018-05:002014-09-27T03:34:38.018-05:00They could be, but would have to be located very c...They could be, but would have to be located very close to the sinus node in order to have the same morphology.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-57853062677387335032014-09-27T01:42:29.711-05:002014-09-27T01:42:29.711-05:00Couldn't P3 and P6 be premature atrial beats? ...Couldn't P3 and P6 be premature atrial beats? I know the P waves all looks very similar, but those two do occur earlier. On the other hand the P3P4 and P4P5 intervals are the same.Anonymoushttps://www.blogger.com/profile/10807079731556500879noreply@blogger.com