Intermittent preexcitation, QRS alternans or intermittent AV Dissociation?


A pt s/p spine surgery. 

This is: 
a. Intermittent preexcitation
b. Intermittent AV dissociation
c. QRS alternans


Image 1 - ECG case


Answer: B. Sinus rhythm (~90 bpm) with premature junctional complexes creating intermittent AV dissociation


Image 2 - Ladder diagram


#499


2 comments:

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  2. SUPERB tracing! For those who are interested — another rhythm strip on this same patient is equally fascinating — https://learningecg.blogspot.com/2015/10/several-tricks-of-pjc-on-one-strip.html — Please see my Comments at that site — :)

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