Atrial Rhythms

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    93 year old male who experiences syncope.

    72 year old female with dyspnea and heart palpitations.

    Questions

    Question 1: How do you know this is sinoatrial exit Wenckebach?

    Key Findings

    -Sinus rhythm with sinoatrial exit Wenckebach

    Coding for Boards

    -Sinus rhythm

    -Sinoatrial exit block

    Answers

    Question 1: The sinus beats occur in groups of 2 in this patient with pauses after each group. The P waves all look identical, suggesting they are sinus beats rather than PACs in a bigeminal pattern. The pauses are less than 2-times the basic sinus interval, which is characteristic of sinoatrial exit Wenckebach.