Heart Rate: The heart rate is 50 beats per minute (BPM), which is bradycardic (slow heart rate). The normal resting heart rate for an adult ranges from 60 to 100 BPM.
Rhythm: The rhythm appears to be regular, with a consistent R-R interval. However, there are no discernible P waves before each QRS complex, suggesting a lack of normal atrial activity.
QRS Complexes: The QRS complexes are narrow and have a consistent morphology, indicating that the ventricular depolarization is likely being triggered by an artificial pacemaker rather than the heart's natural conduction system.
Pacemaker Spikes: There are small vertical spikes visible before each QRS complex, which are characteristic of pacemaker activity. These spikes represent the electrical impulses delivered by the pacemaker to stimulate ventricular contraction.
Kardia Determination: The Kardia device has classified this ECG as "Unclassified," likely due to the presence of pacemaker activity and the lack of normal atrial depolarization (P waves).
Interpretation:
Based on the ECG findings, it appears that the patient has a pacemaker in place, likely a single-chamber ventricular pacemaker (such as the Aveir VR leadless pacemaker) given the absence of atrial activity (no P waves). The pacemaker is functioning appropriately, pacing the ventricles at a rate of 50 BPM.
The lack of atrial activity suggests that there may be an underlying atrial rhythm disorder, such as atrial fibrillation or sinus node dysfunction, which has necessitated the implantation of a ventricular pacemaker to maintain an adequate heart rate.
However, it is important to note that the absence of AV synchrony with single-chamber ventricular pacing can lead to suboptimal cardiac function and potentially pacemaker syndrome in some patients. Close follow-up with a cardiologist or electrophysiologist is essential to monitor the patient's clinical response, assess for any symptoms related to the lack of AV synchrony, and determine if any adjustments to the pacemaker settings or pacing mode are necessary.
In summary, the ECG shows a paced rhythm at 50 BPM with a functioning ventricular pacemaker and an absence of atrial activity. Continued monitoring and clinical correlation are important to ensure optimal patient outcomes and address any potential long-term implications of single-chamber ventricular pacing.
