Open AccessElectrocardiographic Findings in Accessory Right Precordial Leads in Adults and Seniors with Notched S Waves in Lead V 1 —A Preliminary Study
Author(s) -
Zhongqun Zhan,
Nikus Kjell C.,
PérezRiera Andrés Ricardo,
Chongquan Wang
Publication year - 2014
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12114
Subject(s) - precordial examination , medicine , lead (geology) , cardiology , t wave , electrocardiography , geomorphology , geology
Background Atypical right bundle branch block (RBBB) may present with an rS pattern and notched S wave in lead V 1 . The notched S wave may represent slowed conduction or delayed activation of the right ventricular conduction system or ventricular myocardium. Methods We retrospectively analyzed the QRS patterns in accessory right precordial leads (from V 3 R to V 5 R) in 15 adults/senior individuals with notched S wave in lead V 1 . Results In the right accessory precordial leads, 13 showed triphasic QRS pattern with final R′ wave in their QRS complexes. This QRS pattern in association with notched S wave in lead V 1 is suggestive of the presence of RBBB (incomplete or complete). Conclusions A notched S wave in lead V 1 and in the right precordial accessory leads associated with a final R′ wave suggests the possibility of concealed RBBB (incomplete or complete).