Hi Dr. Anthony, thank you so much for your videos, they really do help a lot in the understanding of EKGs! I was wondering if you could do an updated video on LBBB, just like you did for RBBB one year ago? The style of the updated RBBB video really worked wonders. Thank you
Sinus rhythm denotes the rhythm itself is normal. We can clearly see this rhythm wouldn't qualify as "normal" given how there are multiple p waves present. If the ventricular rate is in the 40's as you indicate. How is 'Sinus Tachycardia' even being thrown into the equation? If this were legit Tachycardia, it's highly unlikely an honest Mobitz type II would be this clear, and it's just as unlikely it'd be that fast. Possible? Certainly, anything is possible, but in a 20 year old male who you said is healthy, extremely unlikely. It's difficult to distinguish between Sinus Tachycardia, and Atrial Tachycardia? It's not hard at all; in Sinus Tachycardia you'd clearly see one to one p waves, and QRS Complexes. If you have more than one p wave then it doesn't fit the definition of sinus. The argument for Atrial Tachycardia is valid, and most likely the rhythm. As for needing a pacer.... pump the brakes. No cardiologist is going to suggest a pacer from this one episode. The patient would need to wear a portable telemetry monitor at the least. There would also be a lot of other steps/tests taken prior to authorizing, or suggesting a pace maker.
