Article Text
Image challenge
ECG phenomena: alternating QRS morphologies
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A male newborn was referred to our centre for surgery of a hypoplastic left heart syndrome with atresia of the aortic and mitral valve. He received modified Norwood I procedure with patch reconstruction of the aortic arch and pulmonary artery bifurcation as well as implantation of a conduit between RV and pulmonary artery. Postoperative echocardiography showed good ventricular function and no signs of ventricular dyssynchrony.
Question
What is the cause of the two different QRS morphologies? (figure 1)
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Pre-excitation
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Intermittent bundle branch block (BBB)
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Artefact
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Twin atrioventricular nodes
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Accelerated ventricular rhythm
Answer
From question on page XXX
Answer:D
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