@narrowQRS True.

@narrowQRS This is only with St Jude devices. I see. And the clue is that garbage AMS and VP % in patient with pure SSS and no AV block.

@narrowQRS Interesting. Ya. You are right.

@narrowQRS Other than looking at histograms

@narrowQRS Ya. This is rare nowadays with device programming. That VP into PVC initiates the AP and functional noncapture

@narrowQRS Yup There ya go

@narrowQRS So the AP is functional loss of A capture as it is refractory.

@narrowQRS I am old. I’ve always just called it ELR. Endless loop reentry, which to me always implied PMT under the MTR. Now I know. Thanks

@narrowQRS Yes. Totally agree I see it in MDT devices too. I look at histograms to see if there is a “spike” under MTR. That’s a clue. And yes, very under diagnosed

@narrowQRS It’s basically an Endless Loop Tachycardia under MTR, so not PMT. But ELR

@ecgandrhythmRoe Looks like an ectopic AT with Wenckebach conduction and a sinus beat x 1 after dropped QRS

@IrmaMDv Can you give a little more history ?

@Willis_Kwandou @ecgandrhythmRoe @makkyecg @Frances98392343 @FibrilloFlutter @ecgrhythms @EM_RESUS @DrJNELLY95 @DrAkhilX @TrackYourHeart @EkgHacks I’m not sure if I agree. I am seeing AV dissociation with A rate about 65 and V escape at about 75, with an occasional capture beat. I don’t have red arrows to show, but you can see them marching through just prior to QRS as well as within T waves

@ecgandrhythmRoe NSR with 2nd deg AVN Wenckebach with 3:2 conduction. Longer PR interval conducted beats have BBB aberrancy. Ps all same morph. Sinus

@Willis_Kwandou @PurumittalDr @Frances98392343 @JoySanyal74 @Abdul_alkindy That’s a terrible RV lead position. That’s a macro perforation

@PurumittalDr @ecgandrhythmRoe @EcgOxford @ecgrhythms @JasonWinterECG @EPeeps_Bot @JoySanyal74 @latchumanadhas VP spikes are 1000 ms apart, irrespective of QRS complexes. Perhaps End Of Life switched to VVI 60 with no V capture or sensing?

@SergioPinski @jeffrey_vinocur @adribaran @ecgandrhythmRoe @AThomazAndrade Ah. There ya go. Thanks! Good one