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Reply To: More ECGs for thoughts

Homepage Forums Clinical Discussions More ECGs for thoughts Reply To: More ECGs for thoughts

Liz Bode

Replying to Francois Ravier 07/12/2021 - 13:17

Hi Francois,
Thanks for commenting 🙂
I agree, the HR is approx 100-120bpm with an irregular rhythm.
There is a P:QRS of 1:1, and the P waves are positive in lead II so they have a normal origin (from the SAN).
The QRS complexes are negative in lead II and positive in aVR, so we have a right axis shift, and the QRS complexes are wide and bizarre (so look ventricular in origin). They measure 70ms.
The P wave is normal in size.
The presence of a P wave with a normal PQ interval suggests that the atrial and ventricular activity are connected. You are right in thinking that there is a conduction abnormality, in this case right bundle branch block. So the time it takes for ventricular depolarisation is prolonged, hence the wide QRS.
Great job!