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Beginner ECG 8
The ECG shows sinus tachycardia at about 110 beats per minute with a prolonged PR of 0.22 seconds: first-degree atrioventricular (AV) block. The QRS is wide, about 0.12 seconds, with a left bundle branch block (LBBB) morphology and Q waves in all the chest leads.
The QRS duration is important in the assessment of this tracing, and a tracing run at 50 mm/sec would help clarify the diagnosis. If the QRS is less than 120 msec, then the tracing is consistent with an anterior myocardial infarction (MI) and peri-infarction block. If it is greater than 120 msec, then left bundle branch block is correct.
ECG diagnosis of myocardial ischemia is difficult on an ECG with LBBB; however, there are changes with LBBB that suggest an acute MI. These include Sgarbossa’s criteria, and also Chapman's sign and Cabrera's sign. Visit the Left Bundle Branch Block ECG Review below for details.
Related: Left Bundle Branch Block ECG Review, Sinus Tachycardia ECG Review, First-Degree Atrioventricular Block ECG Review