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Arrhythmia Recognition Webcast Series
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Practice ECG 10
So what's the rhythm? Sinus bradycardia at about 50 BPM. There are very small P waves in most leads, each one paired with a QRS complex. The PR interval is prolonged, so this is a first-degree heart block.
There are also flipped T waves in the inferior leads, suggestive of ischemia. There do not appear to be any other ischemic changes.
What is that mess over in V6? Why does it only occur in V6? Any thoughts? That is just artifact causing the baseline to waver. It is occurring in V6 because someone has moved that lead or the wire attached to that electrode. It would be highly unlikely for the patient to move just one small section of the chest wall in a way that produces such an isolated artifact. If something is found only in one lead, it is usually artifact. However, be careful that the other leads around the one in question do not show an irregularity at the same point. If they do, it can still be artifact but make sure that it is not some superimposed wave or other abnormality.
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