Submitted by jer5150 on Sat, 12/01/2012 - 09:58
Patient's clinical data: 99-year-old black man admitted to the CCU.
Questions:
(1.) What is the name of the format this is laid out in? HINT: All 12-lead ECGs in Sweden are printed out in this format. When you answer, please state whether you prefer this configuration to the "standard" (Einthoven format).
(2.) What do you see in this rhythm tracing?
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Comments
MI
AAWMI/with Q Waves, RBBB 1st degree av BLK
Format
I believe that format is referred to as the Cabrera sequence as it lays out the leads in their respective order (walking clockwise from aVL by 30 degrees). I have to pay a bit more attention when reading it, only as I need to make sure I'm looking at the "right" leads.
Christopher
sixlettervariable.blogspot.com
ems12lead.com
INTERPRETATION
INTERPRETATION:
(1.) Sinus rhythm (rate = 72/min) with . . .
(2.) . . . acute extensive anterior (anterolateral) infarction complicated by . . .
(3.) . . . right bundle-branch block (RBBB)
(4.) "First-degree" A-V block (Prolonged P-R intervals = 0.24s).
COMMENTS:
At the far-advanced age of 99, I'm not sure if the doctors opted to put this patient through an invasive cardiac cath. The RBBB was transient and eventually resolved.
The ECG is laid out in the Cabrera format (also known as the "Panoramic" or "orderly" format). This was adopted at the official format utilized in the country of Sweden however this ECG was recorded in the United States.
For those who've never heard of this format or would like to know more about it, here are two articles about Cabrera:
http://www.sciencedirect.com/science/article/pii/S0022073605802754
http://www.sciencedirect.com/science/article/pii/S0022073604000408
Jason E. Roediger - Certified Cardiographic Technician (CCT)
[email protected]