1. Atrial tachycardia with atrioventricular (AV) block and ventricular bigeminy, resulting from digitalis toxicity. The atrial rate is 164/min and is independent of the QRS rhythm. The QRS complexes are narrow, suggesting an AV junctional origin. Following each narrow QRS complex, a ventricular premature complex occurs (ventricular bigeminy). Because the intervals between the premature ventricular complexes and the normal-appearing complexes are regular and because the premature complexes occur at fixed coupling intervals to the normal complexes, the QRS rhythm is presumed to be regular. Note that some junctional QRS complexes (arrows) appear to be deformed by portions of the superimposed P waves (such deformities can be mistaken for artifacts). (Reproduced, with permission, from Goldschlager N, Goldman MJ. Principles of Clinical Electrocardiography, 13th ed. Originally published by Appleton & Lange. Copyright © 1989 by The McGraw-Hill Companies, Inc.)
Source: Heart Disease, Current Medical Diagnosis & Treatment 2018
Citation: Papadakis MA, McPhee SJ, Rabow MW. Current Medical Diagnosis & Treatment 2018; 2017 Available at: Accessed: October 21, 2017
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