Transient TV1 > TV6 in LGL Conduction
Report:
Sinus rhythm 84/min
Minor non-specific ST/T changes
Early repolarisation, anterior leads
Lown-Ganong-Levine conduction
PR interval 0.12â
Comment:
The patient was admitted following several episodes of precordial discomfort and dyspnÅa, but no palpitations were reported or arrhythmias documented. The ECG was consistent with ischæmia, with TV1 > TV6 and slight ST segment depression in lead aVF.
Those abnormalities resolved over 36 hours (Fig 21a) and a coronary angiogram was normal. He was sent home.
Most likely his ECG changes were left in the wake of a tachyarrhythmia (the post-tachycardia âsyndromeâ), but this remained uncertain. LGL conduction does not mean he had the syndrome.
The P interval should be measured where it is longest â here in lead 2. Itâs just under 0.12â, but as in other leads, there is practically no PR segment between the P wave and the QRS. For some reason, the computer measured it in both tracings as 0.16â â a millimetre longer. Nothing computers do should surprise us.
Fig 21a. Normalised ECG. 22. 75 year old man with precordial discomfort and shock. He died in casualty in less than two hours.
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