can somehow explain this to me please. this gentleman had a | Figure 1

can somehow explain this to me please. this gentleman had a pacemaker set at vvi i believe. he was known to have af. my question is why does it look like there are pacing markers with no following beat? like after the 6th beat for example. and are the smaller more bizarre complexes (5th and 9th of pic1) some capture beats of sorts? he only had PM checked last week. we were called to a trip. thanks.

Called for a 70 y/o female with shortness of breath and chest pain. sitting in tripod position on arrival not alert. CPAP applied resulting in relief of respiratory symptoms. Oddity of the case is her cardiac rhythm. 76 bpm, with every two beats march out with each other but a longer pause between each group of QRS complex. Long PR interval, wider QRS but not resembling ventricular beats. Looks like "bigeminal PJC" if that's a type of beat. Hx of open heart for "CHF issues" but no Hx of AMI. It does not look like a 2nd or 3rd degree block and all QRS produce a pulse. Any other ideas what it could be?

Reaponded for an elderly female, not alert. Pt has dementia baseline..but was only responsive to painful stimuli. All vital signs were WNL, with the pt's husband advised she had barely eaten/drank in the 4 days. Her 12 lead showed only afib, and looked like she was hypokalemic. My question is, what are the ectopic beats in the ECG strips above? Best I could come up with was they are ventricular ectopic beats caused by hypokalemia. But I've never seen this before and I'm curious. The beats were perfusing, and the pt's HR did increase during the runs, but her BP never altered. afib baseline.

transplanted heart restarted and beating a/v paced at 100 BPM. So far so good! You can see the aortic arch stitch and the white wires are pacing leads.

AIVR in a pediatric patient. The aberrant beats were only slightly faster than the sinus beats. He went on to develop 95% aberrant beats but remained asymptomatic.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ECG that would warrant further work-up or is this just a pediatric ECG?