ECG of the Week – 2nd February 2022 – Interpretation

You are reviewing an 80 year old man who has collapsed.

ecg jan 17


  • Rate: 84
  • Rhythm: Sinus
  • Axis: LAD (-30 to -90) – here represents LAFB
  • Morphology: RBBB
  • Intervals: PR 280 QRS 180 QTC 470
  • Summary: Evidence of bifascicular block (RBBB and LAFB) and 1st degree block seen here suggests an Incomplete trifascicular block (a complete trifasciular block being a bifascicular block with CHB)
  • Further Management: take history to exclude overdose or toxidrome, examine for signs of PE or structural heart disease, exclude abnormal K levels, telemetry, admit for consideration of PPM given risk of CHB