Li C, Wang N, Chang Q, Pan D. An interesting electrocardiogram caused by lead reversal.
BMC Cardiovasc Disord 2024;
24:217. [PMID:
38643100 PMCID:
PMC11031905 DOI:
10.1186/s12872-024-03875-2]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/02/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND
During normal sinus rhythm, atrial depolarization is conducted from right atrium to left atrium through Bachmann's bundle, and a normal P wave axis which is measured on the frontal plane is between 0º and + 75º. The change of P wave polarity is helpful for the analysis of origin point.
CASE PRESENTATION
We report a patient with negative P wave in lead I. The characteristics of QRS complex in leads V1 to V6 are helpful to preliminarily differential diagnosis. The 12-lead electrocardiogram (ECG) with correct limb leads (right arm-left arm) placement shows sinus rhythm with complete right bundle branch block (RBBB).
CONCLUSIONS
The change of P wave polarity as well as characteristics of QRS complex can help identify limb-lead reversals.
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