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Retrograde P Waves in Junctional Rhythms: Why They Appear Before, During, or After the QRS junctional rhythms retrograde p waves Sep 17, 2025

In sinus rhythm, atrial activation starts at the SA node and spreads downward, giving us upright P waves in the inferior leads (II, III, aVF) that pre...

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Quick Tip: How to Calculate Heart Rate in Atrial Fibrillation on ECG atrial fibrillation Sep 12, 2025

Atrial fibrillation (AF) gives an irregularly irregular ventricular response, so the usual single-cycle methods (300/large-boxes, 1500/small-boxes) ar...

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Blocked PACs: ECG Findings and Underlying Pathophysiology av block blocked pac pac premature atrial contraction Sep 11, 2025

Premature atrial contractions (PACs) are a common finding on ECG and are usually benign. But sometimes a PAC arrives at the AV node when it is still r...

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Nocturnal Second-Degree Type I AV Block: A Benign Manifestation of Vagal Tone in Sleep 2nd degree type i av block av block mobitz i wenckebach Jun 13, 2025

Second-degree type I AV block, also known as Mobitz I or Wenckebach, is typically characterized by a progressive prolongation of the PR interval follo...

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Fusion Beats in Monomorphic Ventricular Tachycardia ventricular tachycardia (vt) vt Jun 12, 2025

Fusion beats are one of the hallmark findings that support the diagnosis of ventricular tachycardia (VT)—particularly in the case of monomorphic VT. T...

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PVC vs. PAC with Aberrancy (Ashman Phenomenon) aberrancy ashman phenomenon premature ventricular contraction pvc Jun 11, 2025

When confronted with a wide QRS complex that appears unexpectedly on an ECG, one of the key clinical challenges is to determine whether it's due to a ...

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Incomplete vs. Complete Bundle Branch Blocks: Understanding the Degrees of Conduction Delay bundle branch blocks Jun 09, 2025

Bundle branch blocks (BBBs) occur when there's a delay or interruption in the electrical conduction through either the right or left bundle branch of ...

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Electrical Alternans: More Than Just a Pericardial Effusion cardiac tamponade electrical alternans pericardial effusion Jun 08, 2025

Electrical alternans is a fascinating ECG phenomenon typically associated with large pericardial effusion—but it is not pathognomonic for it. This bea...

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Why Left Ventricular Hypertrophy Can Cause Secondary QRS Widening on the ECG left ventricular hypertrophy lvh Jun 07, 2025

Left ventricular hypertrophy (LVH) is most often recognized on ECG by increased QRS voltage—tall R waves in left-sided leads and deep S waves in right...

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How Calcium Channel Blockers Slow the Ventricular Response in Atrial Fibrillation atrial fibrillation calcium channel blockers Jun 06, 2025

Atrial fibrillation (AF) is marked by chaotic atrial activity that can drive the ventricles at dangerously high rates. While the atria may be firing a...

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Understanding AV Nodal Reentry Tachycardia (AVNRT): Mechanism, Initiation, and Treatment Rationale avnrt svt Jun 05, 2025

AV Nodal Reentry Tachycardia (AVNRT) is one of the most common types of paroxysmal supraventricular tachycardia (PSVT), frequently encountered in the ...

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Inferoposterior STEMIs and Complete Heart Block: A Look at AV Node Anatomy and RCA Supply anatomy av block complete av block stemi Jun 04, 2025

Complete heart block—or third-degree AV block—is a feared complication of ST segment elevation myocardial infarction (STEMI), particularly when the in...

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