ECG #11a
ECG #11a

 

ECG #11b
ECG #11b

 

Interpretation

ECG #11a

Rate:

Atrial = N/A

Ventricular = 160 min-1

Rhythm:

Ventricular tachycardia

P waves:  

 

N/A

PR interval:

N/A

QRS complex:

Duration = 142 ms

Axis = -66°

Q Waves:

Nil

R wave progression:

Normal

LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?

No

RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?

No

ST segments:

Duration = 60 ms

Morphology = depressed V5-6

T waves:

Duration = 166 ms

Morphology = inversion aVL

QT interval:

QT duration = 336 ms

QTc duration = 530 ms

Additional comments:

Nil


Interpretation: There is a LBBB pattern of 160 ms duration. There are no discernable P waves and no fusion beats or capture beats. The patient normally had a RBBB, hence the difference in morphology strongly suggests VT. This was part of a tachy/brady ECG sequence (see ECG #11b interpretation below)


ECG #11b

Rate:

Atrial = 167 min-1

Ventricular = 34 min-1

Rhythm:

Complete heart block

P waves:  

Duration = 50 ms

Amplitude = 0.1 mV

PR interval:

 

N/A

QRS complex:

Duration = 130 ms

Axis = 160° (rightward)

Q Waves:

Nil

R wave progression:

Poor

LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?

No

RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?

No

ST segments:

Duration = 200 ms

Morphology = elevation aVR; depression I, II, aVL, aVF, V3-6

T waves:

Duration = 200 ms

Morphology = inversion III, V1

QT interval:

QT duration = 528 ms

QTc duration = 396 ms

Additional comments:

Nil


Interpretation: This ECG shows complete heart block complication a left main insufficiency/occlusion (ST elevation in aVR and depression in 6 or more other leads). This was further complicated by episodes of VT (see ECG #11a). The patient had presented with collapse and was found to be bradycardic. There was no chest pain.

ECG #11
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