Other Notable Findings

What is the Digitalis Effect on an EKG?

ST segment depression with a characteristic sag

What is a Delta Wave associated with?

Wolff-Parkinson-White (WPW) syndrome

What is an Osborn Wave (J Wave) associated with?

Hypothermia

What is the first step in the Turn Signal Method for identifying bundle branch blocks?

In Lead V1, determine if the QRS is wider than 0.12 seconds (3 small boxes)

What should you do if the QRS in V1 is not wider than 0.12 seconds?

Stop the Turn Signal Method

What is the second step in the Turn Signal Method?

Determine if the wide QRS complex in V1 is deflected up or down

What is the third step in the Turn Signal Method?

Picture holding a steering wheel and making a turn

What does a wide QRS deflected up in V1 indicate?

Right Bundle Branch Block (RBBB)

How can you remember a Right Bundle Branch Block (RBBB)?

Right turn, turn signal lever up, wide QRS deflected up

What does a wide QRS deflected down in V1 indicate?

Left Bundle Branch Block (LBBB)

How can you remember a Left Bundle Branch Block (LBBB)?

Left turn, turn signal lever down, wide QRS deflected down

How should a Left Bundle Branch Block (LBBB) be interpreted on a 12-lead EKG?

The interpretation is LBBB

How should a Right Bundle Branch Block (RBBB) be interpreted on a 12-lead EKG?

Interpret whatever findings are present with the RBBB and treat the patient’s clinical presentation and 12-lead findings

What is the Refractory Period?

A critical concept in cardiac electrophysiology