ECG Quiz 43
Discussion
Rhythm strip shows sinus bradycardia with junctional escape rhythm. Junctional escape rhythm is manifested as narrow QRS complexes without preceding P waves. Second and third beats in the rhythm strip have P waves with PR interval of about 200 ms, indicating sinus beats. They may also be considered as sinus capture beats in a junctional rhythm. R wave in V3 is unusually tall. T inversion is noted in I, aVL, V3-V6. They are symmetric and arrow head in V3 and V4, indicating ischemia.