n Cardiovascular Journal of South Africa - The William Nelson ECG quiz

Volume 14, Issue 5
  • ISSN : 1680-0745



Extracted from text ... The William Nelson ECG Quiz The answer is provided on page 237. This is the ECG of a 65-year-old woman. 'My heart beats funny'. Looking closely, it is evident that the 'atrial challenge rate' is approximately 215/min (arrows). Many P waves are buried, but measuring carefully, the P-P cycle is regular. The AV conduction is variable with some stimuli blocked 'high' and the alternating ones conducted with prolonging P-R intervals (Wenckebach block). Of interest, when the Wenckebach 'drop beat' occurs, the previously non-conducted P wave achieves transmission. Dr Alan Lindsay called this the 'leapfrog phenomenon'. This was a single ECG ..

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