Polyphasic or splintered QRS in Ebsteins anomaly of tricuspid valve
Click on the image for a larger view
ECG in Ebsteins anomaly of tricuspid valve showing right bundle branch block (RBBB) pattern with polyphasic and splintered QRS. The QRS is wide and Lead V2 shows rsrs pattern mimicking right bundle branch block. Lead II shows multiple small deflections (splintered QRS). The slurrred S waves in lateral leads also form part of the RBBB pattern.
its very clear from the ecg that the initial QRS is normal and the second QRS portion is abnormal which represents the abnormal atrialized ventricle.
next thing to be considered in this ecg is there is a LAD.We need to be aware of type B preexcitation which is not present in this ECG.
Do not forget to see PR interval[normal in this case]