Assoc Prof Harry Mond
December 2, 2024
Figures 1 and 2 are from a normal control. The tracing is normal in 1 and the leads reversed in 2 so that the arm leads are now on the feet and the leg leads are attached to the arms. Lead I looks at the legs and not the arms and its isoelectric appearance not surprising.I see about two examples of this per month.If you don’t, then you are not looking hard enough!
Figure 3 is a comparison of the lead positions with the classical features listed below.
The ECG should be repeated as important pathology may be missed. For example, the rhythm in figure 4 puzzled us and we eventually went with a supraventricular tachycardia, despite a consistent irregularity and possible p waves in V6. The isoelectric lead I made us ask for a repeat (figure 5). The P waves now emerge and the diagnosis is sinus tachycardia and atrial ectopics
Assoc Prof Harry Mond
To receive a free PDF copy of The Fundamentals of Electrocardiograph Interpretation by Harry Mond, subscribe to his email blog by entering your email address below. Â
Purchase a hard cover or paperback copy of The Fundamentals of Electrocardiograph Interpretation by Harry Mond on Amazon.
May 14, 2025
Fusion is another lesson in timing! Fusion beats are an amalgam of two competing rhythms. Both are responsible for partial depolarization of the respective chambers and depending on the contribution of each, result in progeny with similarities to one or both parents.
May 14, 2025
The ventricular ectopic compensatory pause is a lesson in timing!
