78 year old female patient with coronary artery disease monitored during bypass graft. Patient also has a left atrial enlargement, and an existing inferior infarction.
Rhythm analysis indicates atrial pacing with a left bundle branch block.
This encounter shows a patient undergoing a coronary artery bypass. The patient is on a temporary atrial fixed rate pacing device (AOO), which causes the pacing spikes (sharp vertical lines) seen in place of P waves. Temporary pacing is often utilized to prevent hemodynamic instability due to bradycardia. The patient also has a left bundle branch block, indicated by the wide, notched QRS, and negative voltage to the left of the J point in Lead V1.
Source: PhysioNet MGH072