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All ECG 166

  1. Atrial fibrillation with a slow ventricular response (note the coarse fibrillatory waves)
  2. Limb lead reversal

If the limb lead that was supposed to be attached to the right arm is put on the left arm and vise-versa, a characteristic appearance will be seen on ECG that includes:

1) Predominantly negative P wave, QRS complex, and T wave in lead I (not seen on this ECG due to atrial fibrillation)

2) Predominantly upward P wave, QRS complex, and T wave in aVR

This is the opposite that is seen in a normal ECG. The above findings are similar to that seen in a person with dextrocardia, however if the heart is located in the right side of the chest instead of the left, the voltage in leads V3-V6 will be very low. This would not be seen in simple limb lead reversal. 

Related Topic Reviews: Atrial Fibrillation ECG Review