Ectopy

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    44 year old male asymptomatic.

    44 year old male asymptomatic.

    Key Findings

    - Interpolated PVC

    - Concealed retrograde AV node conduction

    Coding for the Boards

    - Sinus rhythm

    - Ventricular premature complexes

    - Low-voltage, precordial leads

    - Nonspecific ST abnormalities

    Answers

    Discussion: The interesting aspect of this electrocardiogram is the evidence of concealed retrograde AV node conduction. The later coupled PVC, which is the second premature complex, interrupts normally be no conduction as evidenced by the sinus P wave failing to conduct. Further evidence of concealed retrograde AV node conduction is seen in the first premature beat which is interpolated. The sinus beat following that PVC, has a longer PR interval.