Arm lead inversion, sinus tachycardia
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P wave, QRS and T wave are inverted in Lead I and upright in lead aVR, which would suggest a dextrocardia. But the chest leads are not in favour of dextrocardia as the total QRS amplitude increases from V1 to V3, which does not occur in dextrocardia. Hence it is likely to be due to inversion of arm leads (between left arm and right arm). There is sinus tachycardia and over all decrease in the QRS voltages as well as Q waves in inferior leads which appear to be pathological. Clockwise rotation is also seen in the precordial pattern, with a transition zone in V5.
Repeat ECG after correction of leads is given below, which shows upright P, QRS and T waves in lead I and inverted in aVR:
Sinus tachcardia, Q inferior
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