ecg_12lead045.html

Ventricular Pacemaker Rhythm-KH

Frank G.Yanowitz, M.D.

Note the small pacemaker spikes before the QRS complexes in many of the leads. In addition, the QRS complex in V1 exhibits ventricular ectopic morphology; i.e., there is a slur or notch at the beginning of the S wave, and >60ms delay from onset to QRS to nadir of S wave. This rules against a supraventricular rhythm with LBBB.