ECG #3

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Rate:

Atrial = 82 min^-1

Ventricular = 82 min^-1

Rhythm:

Sinus rhythm

P waves:  

Duration = 80 ms

Amplitude = 0.15 mV

PR interval:

Duration = 60 ms

Morphology = normal

QRS complex:

Duration = 130 ms

Axis = -4°

Q Waves:

III, aVF

R wave progression:

Normal

LV Hypertrophy [Sokolow; S_V1 + (R_V5 or R_V6) > 35mm) or R_I + S_III > 25mm]?

Yes

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

No

ST segments:

Duration = 120 ms

Morphology = sagging downslope V1, V2

T waves:

Duration = 120 ms

Morphology = inverted aVL, V1, V2, biphasic I

QT interval:

QT duration = 380 ms

QTc duration = 443 ms

Additional comments:  

Prominent delta wave.

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Interpretation: This is Wolff-Parkinson-White Syndrome type B (prominent S wave in V1, as opposed to the tall R wave observed in type A). The very tall QRS complexes are part of the disease and do NOT represent left ventricular hypertrophy (although these are very tall in this case). This patient was known to have WPW and presented with abdominal pain. This was a routine ECG and the patient was normotensive.

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