STILL HOLDING ON - EKG EXAMPLE No 1

This is the EKG of a 95 year old lady who was recently hospitalized for a hip reconstruction surgery after a fall.
She has a medical history remarkable only for hypertension

EKG analysis

• 1.Sinus rhythm.Every QRS complex is preceded by a P wave.The only exception is the 7th QRS.

It is noted that it is not preceded by a P wave and furthermore it is followed by a pause and it is exactly the same as all the other QRS complexes.Thus this is a premature atrial complex (PAC) probably of  AV node origin since the P wave can not be definitely identified.

• 2.Normal cardiac axis 

• 3.Normal QRS duration

• 4.Normal ST segments (there is a hint of an inverted T in aVL)

Conclusion
Sinus rhythm with one premature atrial complex