{"id":29936,"date":"2019-11-13T05:09:02","date_gmt":"2019-11-13T05:09:02","guid":{"rendered":"https:\/\/johnsonfrancis.org\/professional\/?p=29936"},"modified":"2019-11-13T05:09:02","modified_gmt":"2019-11-13T05:09:02","slug":"ecg-quiz-59-discussion","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-59-discussion\/","title":{"rendered":"ECG Quiz 59 &#8211; Discussion"},"content":{"rendered":"<h2><span style=\"color: #008000;\">ECG Quiz 59 &#8211; Discussion<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/gMLNfz6E7rk\" title=\"YouTube video player\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><br \/>\n<img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-29937\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/11\/EAT-2-1-RBBB-LPHB.jpg\" alt=\"\" width=\"1912\" height=\"950\"><\/p>\n<p style=\"text-align: center;\"><strong><a href=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2019\/11\/EAT-2-1-RBBB-LPHB.jpg\">Click here for a larger image<\/a><\/strong><\/p>\n<p>P waves can be seen at a rate double that of QRS complexes (blue arrows). They are inverted in inferior leads, indicating an ectopic focus from the low atrium (ectopic atrial tachycardia). 2:1 conduction excludes the possibility of an AV node mediated tachycardia which would get terminated with the onset of AV conduction block.<\/p>\n<p>The QRS is very wide (200 ms), with a tall slurred R&#8217; in V1 and a slurred S wave in leads I and aVL. These indicate a complete right bundle branch block. QRS has right axis deviation suggestive of left posterior hemiblock in addition. Fragmented QRS is visible in inferior leads (multiple notches in QRS complex). All these indicate a high risk for ventricular arrhythmias. Such wide QRS is often noted in post operative cases of Tetralogy of Fallot.<\/p>\n<p><a href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-59\/\"><strong>Back to ECG Quiz 59<\/strong><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>ECG Quiz 59 &#8211; Discussion Click here for a larger image P waves can be seen at a rate double that of QRS complexes (blue arrows). They are inverted in inferior leads, indicating an ectopic focus from the low atrium (ectopic atrial tachycardia). 2:1 conduction excludes the possibility of an AV node mediated tachycardia which [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":29937,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[],"class_list":["post-29936","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ECG Quiz 59 - Discussion - All About Cardiovascular System and Disorders<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-59-discussion\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ECG Quiz 59 - Discussion - All About Cardiovascular System and Disorders\" \/>\n<meta property=\"og:description\" content=\"ECG Quiz 59 &#8211; Discussion Click here for a larger image P waves can be seen at a rate double that of QRS complexes (blue arrows). They are inverted in inferior leads, indicating an ectopic focus from the low atrium (ectopic atrial tachycardia). 2:1 conduction excludes the possibility of an AV node mediated tachycardia which [&hellip;]\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/ecg-quiz-59-discussion\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2019-11-13T05:09:02+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-59-discussion\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/ecg-quiz-59-discussion\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"ECG Quiz 59 &#8211; 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