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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Left Axis Deviation in LBBB Conduction
Report:Sinus rhythm 72/min Borderline left atrial abnormality (LAA) Left bundle branch block Comment:In LBBB conduction the axis is derived from the entire QRS complex (unlike the situation with normal or RBBB conduction, where only the initial 0.06â
LBBB with Prominent R Wave in V2
Report:Sinus rhythm First degree AV block PR interval 0.24â Left bundle branch block Comment:Prominent narrow R wave in V2, with subsequent diminution (through V5 in this example) is said to be a sign of old anterior infarction with LBBB. In my expe
Non-Phasic Aberrant Conduction in Interpolated Main-Stem Extrasystoles
Report:Sinus bradycardia 49/min First degree AV block PR interval 0.22â Interpolated junctional (main-stem) extrasystoles Non-phasic aberrant conduction Diffuse T wave changes Comment:The interpolated beats are only slightly different from normal
Phasic Aberrant Conduction in AF: Ashmanâs Phenomenon
Report:Atrial fibrillation with ventricular response 108/min Ashmanâs phenomenon Nonspecific inferior T wave changes Comment:The chest discomfort could be ascribed to AF. In 1947 Gouaux and Ashman published a report of RBBB aberration mimicking VT d
LBBB in Cerebral Hæmorrhage
Report:Sinus rhythm SVEBs Left bundle branch block Primary T wave changes Comment:The patient was on Warfarin for intermittent AF in COCM (EF 30%); the INR was 3.9 at the time of the bleed. Old patients are at very high risk, perhaps due to cerebral a
Variable WPW Conduction
Report:Sinus rhythm 70/min Wolff-Parkinson-White type âBâ conduction Concertina effect Comment:Most of the time the PR interval is so short that the end of the P wave overlaps the delta wave and the P wave may be mistaken for an ectopic deflection
Interpolation and Aberrant Conduction
Report:Atrial rhythm 75/min VEBs, interpolated Rate-dependent incomplete right bundle branch block Nonspecific T wave changes Comment:The actual source of the rhythm is difficult to assign; P inversion in V6 is sometimes held to denote âleft atrial
RBBB as Monophasic R wave in V1
Report:Sinus rhythm 94/min Left anterior hemiblock QRS axis â40o 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, diagnos
Left Posterior Hemiblock Following Aortic Valve Replacement
Report:Sinus rhythm 98/min Right bundle branch block Left posterior hemiblock Axis +115o Nonspecific ST/T changes Comment:One can only diagnose the LPHB with clinical exclusion of RVH. It is easy if the hemiblock suddenly appears or disappears, as in
Incomplete LBBB
Report:Sinus rhythm 94/min Incomplete LBBB Comment:The QRS is just over 0.10â long and, despite large voltages, there are no âseptalâ q waves in 1, aVL and V6. The last of these also shows delayed intrinsicoid deflection, but nobody looks at that