Two Wrongs Making Two Rights!

Report:

Sinus tachycardia 110/min

Left bundle branch block

Left axis deviation

Runs of ventricular tachycardia 150 - 160/min

AV dissociation

Ventricular fusion beats

Comment:

This is from Schamroth himself: two wrongs sometimes make a right60. The two wrongs in the title above are LBBB and the VT; their fusion normalises the QRS twice - at each onset of the VT.

Note the poor performance of Lead 2 in the rhythm strip in demonstrating the VT morphology.

The left axis deviation (LAD) is not normally reported with LBBB; it’s here for didactic purposes, and also to mention that it conveys a worse outlook than normal axis in LBBB conduction61. Approximately 50% of LBBBs have left axis deviation.

If you have any suggestions for or feedback on this report, please let us know.