Small Q waves, representing normal initial depolarization of the intraventricular septum, are normal and commonly seen in the inferior and anterolateral leads (leads 3, aVF, aVL, 1, V5 and V6).
IVCD WITH LAD HOW TO
Learn about these common ECG findings, and how to read ECGs with Executive Electrocardiogram Education () (2) Rarely this pattern is seen in atrial septal defects or pulmonary disease with increased right-sided heart pressures. (2) This pattern is not a precursor of a right bundle branch block or any other significant conduction abnormality. The R wave or R prime is not greater amplitude than the S wave. It may also be called an incomplete right bundle branch block and is described a QRS complex that is < 120 msec with a small R wave, followed by a deeper S wave, and another small R wave seen in V1 and/or V2. (1) RSR’ in V1 or V2Īn rSR’ pattern V1 or V2 can be a normal finding or variant in a younger person or athlete.
Patients with nonspecific intraventricular conduction delays are at almost twice as great a risk of all-cause death and cardiovascular death, as compared with patients without NS IVCDs. Causes include large myocardial infarctions, myocardial fibrosis, amyloidosis, cardiomyopathies or ventricular hypertrophy. Nonspecific Intraventricular Conduction Delay (NS IVCD)Ī nonspecific intraventricular conduction delay (IVCD) is a slowing of conduction through the myocardium, that does not meet the criteria of a right or left bundle branch block. You look at an electrocardiogram (ECG) and it says “ rSR prime in lead V1 or V2” or “borderline left axis deviation.” What does that mean and what do you do? Here, I review multiple common, but puzzling ECG changes and explain what they mean and what can be done about them.
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