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It's the ECG's that george rejects that makes George's ECG's the best.
Long Latency
Report: Sinus rhythm Latent (first degree) AV block PR 0.90” Left anterior hemiblock Right bundle branch block Old anterior infarction Comment: This is the longest sustained first degree AV block I have seen. It is possible that the rhythm is other
The Race Is Not to the Swift…
Report: Sinus rhythm & arrhythmia 58 - 74/min. Left anterior hemiblock (LAHB). Right bundle branch block (RBBB). Second degree AV block, 2:1, rate-dependent. Comment:The patient has, in addition to obvious conduction problems, an abnormally marked sin
Unfinished Wenckebach
Report:Sinus rhythm 76/min Wenckebach phenomenon Atrial trigeminy, possible reentry beats of sinus origin, blocked Frequent VEBs, uniform Positive concordant precordial pattern Left atrial abnormality (LAA) Left anterior hemiblock (frontal axis –60o
Positive Concordant Pattern: Masquerading BBB
Report: Sinus rhythm Left atrial abnormality Possible right atrial abnormality First degree AV block PR interval 0.22” Alternating atrial (?sino-atrial) pacemaker (rhythm strip)[!xe "Alternating atrial pacemaker!] Atrial bigeminy Right bundle branc
RBBB as Monophasic R wave in V1
Report:Sinus rhythm 94/min Left anterior hemiblock QRS axis –40o Right bundle branch block Comment:RBBB can be manifest as pure R wave in V1, especially in the presence of a hemiblock. One could not, without a baseline trace in sinus rhythm, diagnose
Bilateral Bundle Branch Block
Report:Sinus tachycardia 113/min Left anterior hemiblock Right bundle branch block Comment:This is only a bifascicular block – complete right and partial left bundle branch block. The term BBBB is not usually used for this. But if, as here, the patient
Masquerading and Left BBB: BBBB
Report:Atrial fibrillation with rapid ventricular response 150/min Right bundle branch block Left anterior hemiblock Left bundle branch block Bilateral bundle branch block. Nonspecific ST/T changes Comment:In this case one can diagnose BBBB directly
1o AV Block Expressing BBBB
Report: Sinus rhythm 77 – 82/min Left atrial abnormality (LAA) First degree AV block PR 0.22” Intermittent right bundle branch block + left anterior hemiblock PR 0.16” Nonspecific T wave changes Comment: At first, one would postulate a dissociated
Left Axis Deviation: LAHB
Report:Atrial & sinus rhythm 76/min Left atrial abnormality (LAA) Left anterior hemiblock Axis –40o Early transition Left ventricular hypertrophy with ST/T changes Comment:There is a typical qR and rS pattern in leads 1 and 3, respectively. Also the
Invisible LAHB Causing 2:1 AV Block
Report:Sinus tachycardia 120/min 2:1 AV block Right axis deviation +140o Right bundle branch block Possible old anterolateral infarction Comment:The cause of the RAD may be RVH or old anterolateral MI but the former was certainly not present clinical