{"id":28730,"date":"2019-02-24T10:44:52","date_gmt":"2019-02-24T10:44:52","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=28730"},"modified":"2019-02-24T10:44:52","modified_gmt":"2019-02-24T10:44:52","slug":"interesting-trigeminy-ecg-challenge-discussion","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/interesting-trigeminy-ecg-challenge-discussion\/","title":{"rendered":"Interesting Trigeminy &#8211; ECG Challenge &#8211; Discussion"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Interesting Trigeminy &#8211; ECG Challenge &#8211; Discussion<\/span><\/h2>\n<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/-gLaIe7MuYg\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-28731\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/02\/VPC-Fusion.jpg\" alt=\"\" width=\"1892\" height=\"900\" \/><\/p>\n<p style=\"text-align: center;\"><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/02\/VPC-Fusion.jpg\"><strong>Click here for a larger image<\/strong><\/a><\/p>\n<p>The rhythm strip shows ventricular ectopic trigeminy. The beat marked as VPC is a ventricular ectopic beat because:<\/p>\n<ol>\n<li>It is not preceded by a P wave<\/li>\n<li>Has a wide bizarre QRS complex<\/li>\n<li>Secondary ST depression and T wave inversion<\/li>\n<li>Followed by a compensatory pause<\/li>\n<\/ol>\n<p>The next beat marked as a fusion beat:<\/p>\n<ol>\n<li>Has a P wave partly hidden by the QRS (marked by red stepped arrow)<\/li>\n<li>Width and morphology intermediate between the VPC and the next sinus beat (with preceding P wave and narrow QRS).<\/li>\n<li>Occurs just before the next expected sinus beat<\/li>\n<\/ol>\n<p>The ventricular ectopic beat which has fused with the next sinus beat is a late diastolic ectopic as it has occurred after the P wave of the next cycle. In a fusion beat, ventricular activation is partly contributed by the ectopic beat and partly by the conducted sinus beat. The occurrence of fusion beats in ventricular tachycardia has been called Dressler beat after the person who described it [1].<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/interesting-trigeminy-ecg-challenge\/\"><strong>Back to ECG challenge<\/strong><\/a><\/p>\n<p><strong><span style=\"color: #0000ff;\">Reference<\/span><\/strong><\/p>\n<ol>\n<li>William Dressler, Hugo Roesler.\u00a0<a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/0002870352901890\">The occurrence in paroxysmal ventricular tachycardia of ventricular complexes transitional in shape to sinoauricular beats; a diagnostic aid<\/a>. Am Heart J. 1952 Oct;44(4):485-93.<\/li>\n<\/ol>\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Interesting Trigeminy &#8211; ECG Challenge &#8211; Discussion Click here for a larger image The rhythm strip shows ventricular ectopic trigeminy. The beat marked as VPC is a ventricular ectopic beat because: It is not preceded by a P wave Has a wide bizarre QRS complex Secondary ST depression and T wave inversion Followed by a [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":28731,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[1559,4034,4158,4178,4207],"class_list":["post-28730","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library","tag-fusion-beats","tag-trigeminy","tag-ventricular-ectopics","tag-ventricular-trigeminy","tag-vpc"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Interesting Trigeminy - ECG Challenge - Discussion - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/interesting-trigeminy-ecg-challenge-discussion\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Interesting Trigeminy - ECG Challenge - Discussion - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"Interesting Trigeminy &#8211; ECG Challenge &#8211; Discussion Click here for a larger image The rhythm strip shows ventricular ectopic trigeminy. The beat marked as VPC is a ventricular ectopic beat because: It is not preceded by a P wave Has a wide bizarre QRS complex Secondary ST depression and T wave inversion Followed by a [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/interesting-trigeminy-ecg-challenge-discussion\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2019-02-24T10:44:52+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/interesting-trigeminy-ecg-challenge-discussion\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/interesting-trigeminy-ecg-challenge-discussion\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"Interesting Trigeminy &#8211; 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