An interesting electrocardiogram caused by lead reversal

期刊论文
出版模式：

开放获取
发表日期：

2024年4月20日

查看全文

Changjun Li,
Nan Wang,
Qinghua Chang,
Dianzhu Pan

摘要

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.