Cardiophile MD Archive

Supraventricular tachycardia with RBBB pattern (Click on the image for an enlarged view) Supraventricular tachycardia with RBBB pattern as evidenced by the slurred S wave in lead I and aVL and rSR’ pattern in V1. The  right bundle conduction is slower during tachycardia and hence right bundle aberrancy is more likely to occur than left [...]

Incomplete right bundle branch block and left ventricular hypertrophy (Click on the image for an enlarged view) Incomplete right bundle branch block (IRBBB) is manifested as a rsr’ pattern in leads V1 and V2 (C1 and C2 in the image), with T wave inversion in the anterior leads V1 to V5. Left ventricular hypertrophy (LVH) [...]

Complex ventricular ectopy (Click on the image for an enlarged view) Multiple wide bizarre QRS complexes without preceding P waves are ventricular ectopic beats. Since they have different morphologies, they are unlikely to be amenable for radiofrequency catheter ablation. Some of the couplets are seen to be bidirectional while others are unidirectional. In addition, there [...]

Electrical alternans is a phenomenon seen on the electrocardiogram with alternation in the amplitude of QRS complexes. The term electrical alternans totalis is used when the amplitudes of all the waves (P, QRS and T) show alternating amplitude. Electrical alternans totalis is seen in cardiac tamponade and is thought to be due to the heart [...]

Second degree AV block (Click on the image for a larger view) There is a limitation in interpreting the rhythm as a long rhythm strip is not available. This is often the situation when the ECG is obtained without your supervision. The PR interval of the first beat is quite prolonged so that it overlaps [...]