ECG of the Week - 14th December 2015 - Interpretation

The following ECG is from a 50 yr old female who presented with multiple complaints including dysponea, joint pain, abdominal pain and chest pain.

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Labelled Version
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Rate:

• Mean ventricular rate 60 bpm
• Regular atrial activity rate 60 bpm
• Atrial activity marked by red lines

Rhythm:

• Irregular
• Complexes #1-3 sinus
• Complex #4 Premature junctional complex
• Narrow complex with no obvious preceding P wave
• Note non-conducted p wave within T wave
• Followed by compensatory pause
• Complex #5 Premature junctional complex
• Preceding P wave has very short pr (~70 msec)
• Complexes #6-7 sinus
• Complex #8 as per complex #4
• Complex #9 as per complex #5
• Complex #10 sinus

Axis:

• Sinus complexes: Normal axis

Intervals:

• Sinus complexes (#1-3, 6-7 & 10)
• PR - Normal (~160ms)
• QRS - Normal (80ms)
• Premature junctional complexes (#4,5,8,9)
• PR - Absent P wave (#4,8) or very short (#5,9)
• QRS - Normal (80-100ms)

Segments:

• Nil significant changes

Additional:

• Complex #8 has partial RBBB morphology

Interpretation:

• Sinus rhythm
• Frequent premature junctional complexes

References / Further Reading

Life in the Fast Lane

• Premature Junctional Complexes

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.