tag:blogger.com,1999:blog-549949223388475481.post9096142668681007535..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Grouped Beating, What is it?Unknownnoreply@blogger.comBlogger9125tag:blogger.com,1999:blog-549949223388475481.post-9360214352162550792017-03-08T05:35:29.122-06:002017-03-08T05:35:29.122-06:00Excellent explanation.....
Changed my view...
H. M...Excellent explanation.....<br />Changed my view...<br />H. Mirfazaelian M.D. Anonymoushttps://www.blogger.com/profile/11737606601790151924noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-75120925016915237762017-02-10T15:07:54.331-06:002017-02-10T15:07:54.331-06:00Good thought Steve!Good thought Steve!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-81947482498243508632017-02-10T10:42:24.112-06:002017-02-10T10:42:24.112-06:00Thanks, Ken! Another possibility is that it is no...Thanks, Ken! Another possibility is that it is normal Wenckebach, but with sinoatrial exit block which is very common in hyperkalemia. The P-wave often disappears in hyperK even though the sinus node is still firing.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-88187622707243547972017-02-09T17:42:44.706-06:002017-02-09T17:42:44.706-06:00The AV Node is not a single homogeneous structure,...The AV Node is not a single homogeneous structure, but rather consists (electrically at least) of several "layers" — any of which may serve as a site of an escape rhythm. If one sees typical "Wenckebach periodicity" (ie, group beating in a repetitive pattern, especially if the shortest R-R cycle is less than twice the shortest R-R interval) — then this may be indicative of an AV Nodal escape rhythm with Exit Block out of the AV Node. For example, if we see alternating short-long (with all short R-R intervals being the same; and all long R-R intervals being the same) — then this may represent 3:2 Exit Block out of an AV Nodal escape pacemaker, which is essentially 3:2 Wenckebach conduction. Given the multiple different layers within the AV node that may theoretically become involved — this can sometimes produce a highly complex ECG picture. That said, recognition of a regular pattern of "group beating" even when no P waves are seen DOES suggest the possibility of Wenckbach conduction. That said, in my earlier comment I indicated why we do not have typical Wenckebach periodicity here.ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-82070567754565886832017-02-01T11:53:01.004-06:002017-02-01T11:53:01.004-06:00AV nodal Wenckebach is in the differential. I fra...AV nodal Wenckebach is in the differential. I frankly don't understand that phenomenon very well, so I did not go into it!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-9015594561424005302017-01-30T01:29:21.624-06:002017-01-30T01:29:21.624-06:00thank youthank youAnonymoushttps://www.blogger.com/profile/07052330051789958982noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-8958203883388260342017-01-29T14:31:29.144-06:002017-01-29T14:31:29.144-06:00Is Wenckebach In differentials? I can not see any ...Is Wenckebach In differentials? I can not see any p waves....Hadimirhttps://www.blogger.com/profile/03853224000467358889noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-43908227122402403252017-01-27T21:34:23.118-06:002017-01-27T21:34:23.118-06:00Thanks for posting my contribution Steve. Keep up ...Thanks for posting my contribution Steve. Keep up the great work with your blog! — )ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-42870544945182517952017-01-27T17:56:21.537-06:002017-01-27T17:56:21.537-06:00Hyper K, (absent p-waves, peaked T-Waves, and my i...Hyper K, (absent p-waves, peaked T-Waves, and my initial reaction of WTF ((sorry millennial paramedic here...)), leading to trigeminal PAC with a sinus pause, and....repeat b-climbhttps://www.blogger.com/profile/06117587083757973747noreply@blogger.com