ECG of the Week - 11th June 2012 - Interpretation

Another ECG on the same patient as the last 2 weeks.

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Rate:

• 35

Rhythm:

• Regular
• Absent p waves

Axis:

• Normal (+45 deg)

Intervals:

• PR - p waves absent
• QRS - Normal (120ms)
• QT - 360ms (QTc Bazette ~ 270 ms)

Additional:

• T Inversion aVR, V1

Interpretation:

• Junctional Bradycardia
• Junctional Escape 
• QRS Morphology similar to previous ECGs

Differential

• Drugs - patient received beta-blockers, unknown as whether on calcium-channel blockers or digoxin
• Ischaemia
• Sinus Node Dysfunction - Tachy-Brady Syndrome
• Electrolyte Abnormalities e.g hyperkalaemia

References / Further Reading

Life in the Fast Lane

• Junctional Rhythm here
• Sinus Node Dysfunction here

Textbook

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