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ECG show wide QRS complex with rSR’ pattern in V1 and slurred S wave in leads I, aVl, V5 and V6 suggesting right bundle branch block. Lead 3 shows a deep S wave and RSr’ pattern. Lead aVf also has a deep S wave. Lead II is almost equiphasic. If lead II was also negative we could have thought of additional left anterior hemiblock. ST depression and T wave inversion in leads V1 to V3 are secondary to right bundle branch block. Presence of such prominent R’ as in this case would make one suspect additional right ventricular hypertrophy. The QRS width is about 150 milliseconds. Such patterns are often seen after repair of tetralogy of Fallot. In those who have undergone repair of tetralogy of Fallot, the chance of ventricular arrhythmias increase with increasing QRS duration.