Wednesday, 14 May 2014

ECG of the Week - 12th May 2014 - Interpretation

One of the old ECG's in my collection, no clinical information on this one.

Click to enlarge

Rate:
  • 78 bpm
Rhythm:
  • Regular QRS
    • Preceded by abnormal P wave
Axis:
  • Right axis deviation
Intervals:
  • PR - Normal (120ms)
  • QRS - Normal (70ms)
  • QT - 330ms (QTc Bazette 390 ms)
Segments:
  • Normal

Additional:
  • P wave inverted leads II, III, aVF, V3-6
  • Positive P wave lead aVR
  • T inversion lead III

Interpretation:
  • Ectopic atrial rhythm
    • Low atrial focus - inverted P waves in inferior leads
    • Normal pr interval favors atrial rather than junctional focus
  • Right axis deviation

Ectopic atrial rhythms can occur in the absence or presence of structural heart disease, and occur when the ectopic site rate is faster than the sinus rate. It may not reflect any underlying pathology and can occur with increased vagal tone, drug toxicity, and ischaemia.

References / Further Reading

Life in the Fast Lane

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