Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
151 Right Bundle Branch BlockRight Bundle Branch BlockKnowledge Weavers ECG
152 2nd degree AV block, type I, with accelerated junctional escapes and a ladder diagramThe ladder diagram illustrates a Wenckebach type AV block by the increasing PR intervals before the blocked P wave. After the blocked P wave, however, a rev-ed up junctional pacemaker terminates the pause. Note that the junctional beats have a slightly different QRS morphology from the sinus beats...Knowledge Weavers ECG
153 Atrial tachycardia with exit block and AV blockThe ectopic P waves, easily seen in this example,occur in groups, separated by short pauses. This is likely due to an exit block just distal to the atrial pacemaker. Because not all of the P waves make it to the ventricles, there is also 2nd degree AV block. Therefore, two levels of block are pre...Knowledge Weavers ECG
154 LVHIn this example of LVH, the precordial leads don't meet the usual voltage criteria or exhibit significant ST segment abnormalities. The frontal plane leads, however, show voltage criteria for LVH and significant ST segment depression in leads with tall R waves. The voltage criteria include 1) R in a...Knowledge Weavers ECG
155 A nonconducted PAC causes an unexpected pauseUnexpected pauses in rhythm have several causes, the most frequent being a nonconducted PAC. In this example the nonconducted PAC is seen in the ST segment of the pause. Note the change in the ST-T compared to the other ST-T waves.Knowledge Weavers ECG
156 Giant TU fusion wavesTU fusion waves are often seen in long QT syndromes. The differential diagnosis of this ECG abnormality includes electrolyte abnormalities -hypokalemia, CNS disease, e.g., subarachnoid hemorrhage; hereditary long QT syndromes, and drugs such as quinidine.Knowledge Weavers ECG
157 Left anterior fascicular block (LAFB)LAFB is the most common of the intraventricular conduction defects. It is recognized by 1) left axis deviation; 2) rS complexes in II, III, aVF; and 3) small q in I and/or aVL.Knowledge Weavers ECG
158 Atrial flutter with 2:1 AV conduction: lead V1The arrows point to two flutter waves for each QRS complex. Atrial rate = 280; ventricular rate = 140.Knowledge Weavers ECG
159 Long QT Interval and Giant Negative T WavesLong QT Interval and Giant Negative T WavesKnowledge Weavers ECG
160 Frontal plane QRS axis = -15 degreesFrontal plane QRS axis = -15 degreesKnowledge Weavers ECG
161 Ventricular pacemaker rhythmNote the small pacemaker spikes before the QRS complexes in many of the leads. In addition, the QRS complex in V1 exhibits ventricular ectopic morphology; i.e., there is a slur or notch at the beginning of the S wave, and>60ms delay from onset to QRS to nadir of S wave. This rules against a suprav...Knowledge Weavers ECG
162 Diffuse anterolateral T wave abnormalitiesDiffuse anterolateral T wave abnormalitiesT Wave AbnormalitiesKnowledge Weavers ECG
163 Frontal plane QRS axis = -45 degreesFrontal plane QRS axis = -45 degreesKnowledge Weavers ECG
164 Marked sinus arrhythmia - marquetteMarked sinus arrhythmia - marquetteKnowledge Weavers ECG
165 Muscle tremor artifact - marquetteMuscle tremor artifact - marquetteKnowledge Weavers ECG
166 RBBB + LAFB: bifascicular blockRBBB + LAFB: bifascicular blockKnowledge Weavers ECG
167 ECG of the century: A most unusual 1st degree AV blockOn Day 1, at a heart rate of 103 bpm the P waves are not clearly defined suggesting an accelerated junctional rhythm. However, on Day 2, at a slightly slower heart rate the sinus P wave suddenly appears immediately after the QRS complex. In retrospect, the sinus P wave in Day 1 was found burried i...Knowledge Weavers ECG
168 RBBB plus mobitz II 2nd degree AV blockThe classic rSR' in V1 is RBBB. Mobitz II 2nd degree AV block is present because the PR intervals are constant. Statistically speaking, the location of the 2nd degree AV block is in the left bundle branch rather than in the AV junction. The last QRS in the top strip is a junctional escape, since...Knowledge Weavers ECG
169 Left axis deviation: QRS axis = -60 degreesLead aVR is isoelectric; leads II and III are mostly negative. The QRS axis, therefore, is -60 degrees.Knowledge Weavers ECG
170 QRS axis = +30 degreesLead III is isoelectric; leads I and II are positive. The QRS axis, therefore, is +30 degrees.Knowledge Weavers ECG
171 Pacemaker failure to sense - marquettePacemaker failure to sense - marquetteKnowledge Weavers ECG
172 Pacemaker fusion beat - marquettePacemaker fusion beat - marquetteKnowledge Weavers ECG
173 RAE & RVHRAE & RVHKnowledge Weavers ECG
174 Type II, 2nd degree sino-atrial blockTwo types of 2nd degree SA block have been described. In type-I, or SA Wenckebach, the P-P interval of the pause is less than 2x the preceding P-P intervals. In type-II SA block the P-P interval of the pause is approximately 2x the normal P-P interval. The distinction between types I and II is no...Knowledge Weavers ECG
175 Bradycardia-dependent LBBB with carotid sinus massageWhen carotid sinus massage slows the heart rate in this example, the QRS widens into a LBBB. This form of rate-dependent bundle branch block is thought to be due to latent pacemakers in the bundle undergoing phase 4 depolarization; when the sinus impulse enters the partially depolarized bundle, slow...Knowledge Weavers ECG
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