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