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Ventricular Pacing Versus Normal Sinus Rhythm

As a cardiothoracic anesthesiologist and intensivist, many of my patients receive ventricular pacing at some point during their hospital admission. In the OR, many patients have epicardial right ventricular (RV) pacing implanted following cardiac...

S1-Q3-T3 EKG Pattern

S1-Q3-T3 refers to an EKG pattern first described in the 1930s suggestive of cor pulmonale in a case series of patients with pulmonary embolism (PE). This pattern has the following findings: Prominent S wave in...

Right Bundle Branch Block EKG Findings

In right bundle branch block (RBBB), the His-Purkinje conduction system cannot conduct normally into the right ventricle (RV). Therefore, the RV is depolarized across the interventricular septum AFTER the left ventricle (LV) is depolarized....

“Is This EKG Real Or Artifact?”

In the world of perioperative and intensive care medicine, I'm surrounded by continuous monitors; however, it's important to understand how monitors work (and the pitfalls associated with them) before one interprets the numbers they...

Apple Watch ECG Captures Pacemaker Activity

The hysteria surrounding Apple Watch 4's single lead electrocardiogram (ECG) feature has simmered down over the last few months, but it was brought to my attention that pacemaker activity can also be detected by...

EKG Axis Deviation

Normal cardiac conduction propagates downward and leftward from the SA node to the His-Purkinje system. Thus, lead I (points to the patient's left) and lead aVF (points straight down) represent the component vectors in the x and y planes,...

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