ECG Quiz 14
ECG Quiz 14 – Choose the best answer:
a) Left bundle branch block
b) Right ventricular apical pacing
c) AV sequential pacing
d) Left bundle branch block with 2:1 AV block
Discussion available in the YouTube video here.
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Johnson Francis
Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal
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Lbbb with2:1 av block
d
LBBB WITH 2:1av block with concordant T waves in LATERAL leads
Plus hyperkalemia also be ruled out
Wide negative QS complexes from V1-V4 having LBBB morphology and 2:1 conduction of the Atrial impulses. P waves are of normal morphology and so the Pacer spikes can be ruled out.
Hence, D) Left bundle branch block with 2:1 AV block
d) LBBB with 2:1 AV block
Most likely this represents a Mobitz II AV block because of the LBBB unless there is a previous tracing demonstrating the same LBBB without a 2:1 block. There is a late transition in the precordium although no left axis deviation is present. The left-sided leads (I, aVL, V5, V6) show an inappropriate concordance of the QRS and T deflections indicating probable ischemic heart disease. The modified Smith-Sgarbossa calculations do not suggest any hidden STEMI.
D
D
Ans is D. LBBB with 2:1 A.V Block
D
Lbbb with 2:1 av Block.
No evidence of of recent mi if lbbb is pre-existing (By Smith modified sgarbossa criteria or Cabrera notch or Chapman sign not seen).
There is 2:1 conducting mobitz type 2 Av Block
Correct answer
Correct answer
Correct answer
Correct answer
Correct answer
Correct answer
Correct answer
Correct answer