Ectopy

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    85 year old female with palpitations.

    85 year old female with palpitations.

    Key Findings

    - Sinus rhythm

    - PACs with left bundle aberration

    Coding for the Boards

    - Sinus rhythm

    - Atrial premature complexes

    - Aberant conduction

    - Nonspecific ST abnormalities

    Answers

    Discussion: This is phase 3 left bundle aberration which persists for a few beats in the middle of the strip due to transseptal concealed conduction. The T wave changes could be coded as due to ischemia, but given vignette, are best described as nonspecific.