Atrial fibrillation with accelerated junctional rhythm with type I exit block
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This is the proposed ladder diagram of the post yesterday.

You have to look farther to appreciate the group beating (think of the footprints of a Wenckebach). There is a group of 4 and 3 with some shortening of the RR interval. This is followed by a long cycle. This cycle is less shorter than the 2 preceding cycles.

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I got this formula from almost the same tracing in Fig 13-4 of Dr. Fisch and Knoebel's book - http://www.amazon.com/Electrocardiography-Clin…/…/0879934468

The rate of the junctional pacemaker is estimated by adding the cycles of the Wenckebach sequence (5). I used an electroni caliper in this case (3663 ms). Thi is divided by the five junctional cycles which gives us interectopic interval of about 732 ms (or ~83 bppm). beige or ivory color wears for a wedding

Thus, this is atrial fibrillation with accelerated junctional rhythm with type I exit block.

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