All pacemaker companies have programmable algorithms to prevent ventricular pacing, but this can cause issues with Holter monitor test results. Our Medical Director, Dr Harry Mond, explains how pacemakers can confuse Holter monitor tracings, and how to correctly identify these algorithms on ECG patterns.

After recently discussing the two most common variations of reversed arm and leg leads, we now explore combinations of Right Arm-Right Leg Reversed, including the double twists, & all the tell-tale footprints.

We explore the many variations of Wenckebach AV block with a pivotal focus on the atypical, typical and absolute occurrences. We also define the three features needed in order to make a correct diagnosis.

This week, Dr Harry Mond explores biventricular pacing, often referred to as simultaneous depolarisation of the right and left ventricles and how it's an indication for permanent cardiac pacing.

Last week we proved not all bundle branch blocks are boring. Now we delve even deeper into mistaken rhythms, common misdiagnosis and those rarely talked about, including the crochetage sign

AV with slow ventricular response. The rate is 40BPM. In the good old days this was digitalis toxicity until proven otherwise. The clue is Bifascicular block. Many cardiologists are reluctant to call this complete heart block as there is no AV dissociation.Don’t be scared to call this complete heart block because that is what it is!!

Further to our pacing series, Dr Harry Mond analyses one of the most difficult cases he has seen in a bid to teach us about Conduction System Pacing and how 'His' bundle pacing can be recognised.

This ECG was reported as complete heart block, and at first glance it sure looks like it. But a closer examination revealed the ventricular response was irregular. In this latest case study Assoc Prof Harry Mond explains two P wave patterns that reveal the rhythm as an alternating Wenckebach AV block, along with the characteristics of the rhythm and how to make sense of them.

Last week some of you suggested dextrocardia in response to our case of reversed arm leads. This week shows that with dextrocardia the chest leads are very different and how to avoid misdiagnosis