12 lead question; Whats this?

[Hockey]

On moi


Whats up with AVF? Thats the only one its on. Its not the greatest 12 lead since I moved a bit. Kind of wide too

Click to enlarge

 

[8jimi8]

Looks like a right bundle branch block. I'd like to put some calipers on it.

QRS >0.1, but <0.14 is an incomplete bundle branch block. >.014 is a complete block

 

[TomB]

Are you referring to the notch on the QRS complex? It's nothing to worry about. This looks like a normal ECG to me.

 

[TomB]

BTW the QRS duration does not have to be 140 ms to be a bundle branch block. 120 ms is sufficient.

 

[8jimi8]

BTW the QRS duration does not have to be 140 ms to be a bundle branch block. 120 ms is sufficient.

But isn't between .11 and .139 technically an incomplete? That is what literature I've seen.

 

[rhan101277]

I thought LBBB was best detected in V1 with a >120ms QRS

If you take a left after the J point u got a left BBB. I can't tell from this one if it has a long enough duration.

You can have LBBB that people have that are just from being old, or they have previously damaged areas of the myocardium. Its always good to take a good history.

 

[8jimi8]

rhan, no one is talking about lefts hehe

 

[TomB]

Incomplete bundle branch blocks have QRS durations < 120 ms but similar morphology to RBBB or LBBB. (With incomplete LBBB there is typically a secondary ST-T wave abnormality that can make it looks similar to LVH).

Bottom line is this:

A supraventricular rhythm with QRS duration = or > 120 ms is an intraventricular conduction defect. If it meets the morphology requirements it can be further classified as RBBB or LBBB (or bifascicuar block).

If it doesn't match either RBBB or LBBB (or shows RBBB in the limb leads and LBBB in the precordial leads, or LBBB in the limb leads and RBBB in the precordial leads) then it's a nonspecific intraventricular conduction defect.

Tom

 

[8jimi8]

Incomplete bundle branch blocks have QRS durations < 120 ms but similar morphology to RBBB or LBBB. (With incomplete LBBB there is typically a secondary ST-T wave abnormality that can make it looks similar to LVH).

Bottom line is this:

A supraventricular rhythm with QRS duration = or > 120 ms is an intraventricular conduction defect. If it meets the morphology requirements it can be further classified as RBBB or LBBB (or bifascicuar block).

If it doesn't match either RBBB or LBBB (or shows RBBB in the limb leads and LBBB in the precordial leads, or LBBB in the limb leads and RBBB in the precordial leads) then it's a nonspecific intraventricular conduction defect.

Tom

Thanks Tom!

 

[MSDeltaFlt]

Incomplete bundle branch blocks have QRS durations < 120 ms but similar morphology to RBBB or LBBB. (With incomplete LBBB there is typically a secondary ST-T wave abnormality that can make it looks similar to LVH).

Bottom line is this:

A supraventricular rhythm with QRS duration = or > 120 ms is an intraventricular conduction defect. If it meets the morphology requirements it can be further classified as RBBB or LBBB (or bifascicuar block).

If it doesn't match either RBBB or LBBB (or shows RBBB in the limb leads and LBBB in the precordial leads, or LBBB in the limb leads and RBBB in the precordial leads) then it's a nonspecific intraventricular conduction defect.

Tom

The term I've always heard was conduction "delay".

 

[TomB]

You're welcome! The terms are interchangeable.

Tom