Wide Complex Rhythms
- Agonal paced rhythm likely
- Severe QRS widening compatible with acidosis and severe hyperkalemia
- LVAD motor artifact
- Ventricular pacer normally functioning
Discussion: This is a V paced rhythm in a person with an LVAD. This noise is characteristic of LVAD noise. Severe hyperkalemia affects QRS duration because of its indirect inactivation of sodium channelsdue to generalized depolarization.