ECG of the Week - 14th May 2012 - Interpretation

No clinical information on this one.

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Rate:

• 78

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• LAD (-75 deg)

Intervals:

• PR - Normal (~200ms)
• QRS - Prolonged (~140)
• QT - 400ms (QTc Bazette ~ 460 ms)

Segments:

• Slight ST depression V2
• Slight ST elevation II, III, aVF

Additional:

• RBBB Morphology
• T Inversion V1-3, aVR, aVL
• Notching p waves in lead II

Interpretation:

• Bifasicular Block - RBBB with LAFB

• Note if 1st or 2nd degree AV with Bifasicular block then Incomplete Trifasicular Block
• Risk of progression to complete heart block is low with bifasicular block and higher with trifasicular block
• New bifasicular block can be associated with hyperkalaemia

References / Further Reading

Life in the Fast Lane

• Bifasicular Block here
• Trifasicular Block here

Textbook

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