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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
LBBB: Intermittent LAD
Report: Sinus rhythm SVEBs Left bundle branch block QRS 0.125â Intermittent left axis deviation â50o Comment: Approximately 50% of LBBBs have LAD; this one had LAD 50% of the time! How or why the predivisional LBBB becomes divisional, and back ag
Verapamil Overdose
Report: Sinus bradycardia 37/min 2:1 second degree AV block 1o AV block in conducted beats Left bundle branch block Primary T wave changes Comment: The lack of sinus tachycardia is very unhealthy in this situation; much of it could be ascribed to ver
IVCD & ST/T Alternans: Tricyclic Overdose
Report:Broad complex tachycardia of uncertain origin QRS 0.28â Probable atrial ? sinus tachycardia ST/T alternans Comment: The patient was in coma, but not fitting; in shock, but not circulatory collapse; the QRS was well over 0.16â, but there wer
Bilateral Bundle Branch Block
Report:Sinus tachycardia 113/min Left anterior hemiblock Right bundle branch block Comment:This is only a bifascicular block â complete right and partial left bundle branch block. The term BBBB is not usually used for this. But if, as here, the patie
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
Gradual Completion of LBBB
Report: Sinus rhythm SVEBs Incomplete left bundle branch block Complete left bundle branch block, rate-dependent Comment: The tall monophasic R complexes in 1 and V6, with slightly delayed peak (late intrinsicoid of yore) and no preceding septal q wav
RBBB & Contralateral Escape Beats
Report: Atrial fibrillation with slow response Right bundle branch block Borderline left axis deviation â30o Ventricular escape beats with left bundle branch block morphology Nonspecific ST/T changes Comment: One instinctively looks (or should look
Supernormal Conduction in RBBB
Report:Sinus rhythm 72/min SVEBs, one couplet Right bundle branch block Supernormal conduction Comment:The SVEBs are all preceded by Pâ, resetting the sinus pacemaker. What is unusual and unexpected is their normal intraventricular conduction despit
Atypical LBBB: Anterolateral Q Waves
Report: Sinus rhythm SVEBs, runs of SVT Left axis deviation â50o Intraventricular conduction delay, probably atypical left bundle branch block Probable old anterior infarction ST/T changes suggest infarction/ischæmia. Comment: Post-arrest ECGs (a
Doxepin Overdose: IVCD
Report: Junctional tachycardia 100/min Intraventricular conduction delay (IVCD) QRS 0.16â Comment: The QRS duration of 0.16â implies the likelihood of nasty arrhythmias27, but its clinical usefulness is limited by the fact that patients with it nee