Interesting Trigeminy – ECG Challenge – Discussion

Interesting Trigeminy – ECG Challenge – Discussion

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The rhythm strip shows ventricular ectopic trigeminy. The beat marked as VPC is a ventricular ectopic beat because:

  1. It is not preceded by a P wave
  2. Has a wide bizarre QRS complex
  3. Secondary ST depression and T wave inversion
  4. Followed by a compensatory pause

The next beat marked as a fusion beat:

  1. Has a P wave partly hidden by the QRS (marked by red stepped arrow)
  2. Width and morphology intermediate between the VPC and the next sinus beat (with preceding P wave and narrow QRS).
  3. Occurs just before the next expected sinus beat

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