Is this a escape or a PVC?

[odvecchi]

I'm quite confused of this wave, it looks like a PVC and not a BBB or ventricular escape at all (as there is no pause or bradicardia).

http://imageshack.com/a/img540/5955/TS3M2z.jpg

Thanks.

[odvecchi]

In the same holter result I had 6 PVCs and 1 PACs

Maybe its a pathway that is rarely activated or soma kind of "external" cause that irritate the heart, because this was the only pre-excited beat in the holter result. If it was a W-P-W the other complex would have delta waves too right?

Gonna see my doctor today.

[is_something_wrong]

When I think about it, it looks more and more like a pre-excitated beat. The PR interval on this beat is very low and you can see a marked delta wave, more than you usually get with PVCs.

Maybe you have an extra pathway in your heart that is occationally activated? I don't know, maybe you should ask your doctor.

[is_something_wrong]

It's neither. It's a normal beat with BBB or which is pre-excitated. I don't know for sure, I'm not a doctor, but it's not a PVC.

As you can see, there is a normal sinus P wave before the beat. So it's initiated in the atria, and it's not premature.