Sinus bradycardia with premature atrial beats
Fatigue and Unusual Thirst
A 61-year-old woman receiving treatment for urothelial cancer presents with fatigue, polyuria, and polydipsia.
Look for
- Slow underlying sinus rhythm, reported as 57/min.
- Premature atrial beats reported on the ECG.
Where to look. In II and V1, compare P waves and identify early beats.
The underlying rhythm is slow, with some atrial impulses arriving early. An isolated premature beat does not turn an organized rhythm into atrial fibrillation.
Premature atrial beats explain some early beats, rather than persistent complete irregularity.
References & provenance
The ECG Made Easy, 9e, ch. 4, PDF 91–93; Lilly, 6e, ch. 12, p. 288.
Amr Essa; Osama Diab; Ahmed Munir; Venkata Andukuri. Transient Asymptomatic Sinus Bradycardia and Sinus Pauses with Bevacizumab: Case Report and Literature Review. 2019. doi:10.7759/cureus.6177. Figure 1. CC BY 3.0. CC BY 3.0
Adaptation: cropping and removal of headers/annotations outside the tracing where applicable; metadata removed. Waveforms have not been redrawn.
Compared with the published source; no independent clinical validation is claimed.
Original annotations & limitations
Bradycardie sinusale avec extrasystoles atriales
Femme de 61 ans traitée pour un cancer urothélial; fatigue, polyurie et polydipsie; bradycardie sinusale à 57/min avec extrasystoles atriales.
Contexte métabolique complexe; question centrée sur le rythme. Ne pas imputer automatiquement l’ECG à un médicament.