Eventually a “sine wave” pattern ensues ... leads in the setting of left ventricular hypertrophy. The most common ECG finding of an acute pulmonary embolism is sinus tachycardia; however ...

This ECG occured in the setting of a potassium level of 8.2 which is very high. A "sine wave" pattern subsequently ensued, thus this ECG change was a precursor to the classic "sine wave" of ...