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All ECG 113

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Source: Learn the Heart

The rhythm is normal sinus at a rate of about 70 beats per minute. The fourth beat is a premature atrial contraction conducted with a slightly longer PR interval. The P wave is terminally inverted in V1. The QRS amplitude in leads II and AVF is about 20 mV; there is an S wave in V1 of 17 mV with an R V5 of 18 mV. 

The voltage changes are consistent with left ventricular hypertrophy.

Related: Left Ventricular Hypertrophy (LVH) ECG ReviewPremature Atrial Contractions (PACs) ECG Review