Alaskan Man is Concerned About Going Home

ANSWER


The correct interpretation includes normal sinus rhythm with a premature supraventricular complex, a rightward axis, and a QR pattern in V1 suggestive of right ventricular conduction delay.

The eighth beat in the rhythm strip is the premature supraventricular complex. It occurs earlier than the rate of the normal sinus rhythm, and there is a compensatory pause prior to resumption of the next sinus beat.

A right axis is evidenced by an R-wave axis > 100° and is common in chronic obstructive pulmonary disease. Right ventricular conduction delay, or incomplete right bundle branch block, occurs when conduction is slowed through the right bundle. ECG criteria include an RSR’ or QR pattern with a QRS duration of 100 to 120 ms, with similar terminal features of a normal QRS. In this case, the QRS pattern is < 100 ms; however, the QR pattern in lead V1 is suspicious.