ECG of the Week - 9th April 2012 - Interpretation

This weeks ECG is another ECG taken from last weeks 82yr old female.

Click to enlarge

Rate:

• 83

Rhythm:

• Paced
• Regular

Axis:

• LAD (-73 deg)

Intervals:

• PR - Ventricular Paced Rhythm
• QRS - Prolonged (160ms)
• QT - 720ms (QTc Bazette ~ 820 ms)

Segments:

• ST Elevation II, III, aVF, V4-5
• ST Depression I, aVL, V2, V6

Additional:

• T Inversion I, aVL, aVR, V2
• P waves V2,3 following QRS
• Prominent R wave I, aVL, aVR, V6

Interpretation:

• Paced Rhythm
• LBBB Morpholgy & LAD
• ST Segment & T wave Changes - Appropriate discordance in keeping with paced rhythm
• ? Retrograde p waves ? Native activity
• QT Prolongation - ? can you comment on in paced rhythm ?

  

References / Further Reading

Life in the Fast Lane

• Paced Rhythms here

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.