Thank you all for your thoughts.
The pt was sedated and cardioverted and her sinus ECG is attached. This
episode was actually a few years ago, but I was going through some ECGs
with the new SHOs and this lead to a discussion on capture & fusion
beats.
The ECG was shown to a load of SpRs & consultants in Manchester and
all of the above diagnoses were made ( so Bruce you have probably seen
it already!)
The question I was interested in is the presence of fusion & capture
beats is said to be proof of VT........ clearly this is not the case
here, as there are definite beats on the rhythm strip where the atria
have captured the ventricles and also some fusion/?delta waves in the
chest leads too.
And indeed the 12 lead looks typical of an accessory pathway &
AF......now that I have spent some time looking at them.
So at the risk of displaying my ignorance, I presume therefore that
capture and fusion beats are only of value if the rhythm is defintely
NOT AF............
Cue long email from Dr Morris!
Cheers
Peter
Dr Peter A Cutting
Consultant in Emergency Medicine
Leeds General Infirmary
Tel 0113 3926470
Fax 0113 3922810
|