To the right, or to the left?

The art of ECG interpretation has become a mystery to me.  I know the basics.  I can pass the National Registry exam with flying colors. But since I have met some real masters of ECG interpretation, I realized that there is so much more to know – so much more to understand.  A good friend, and ECG wiz kid, told me: “You need to read things with some meat to it.”  This is so true!  ECG interpretation is so much more than just pattern recognition. You have to have a deeper understanding of what actually happens in the heart.

For an example, let us talk about ventricular ectopies for a minute.  We are all familiar with a premature ventricular contraction, more commonly referred to as simply a “PVC”.  A PVC is a relatively common event where the electrical complex of the heart is initiated by Purkinje fibers in the ventricles rather than by the sinoatrial node.  To recognize it on an ECG is easy – look for the “funny looking beat” (FLB) that is wide and ugly.

From Wikipedia, the free encyclopedia

However, if you want to determine if a PVC originated from the right or the left ventricle, then head on over to ems12lead.com and learn from real masters of ECG interpretation. Not only will you learn that “… ventricular complexes that originate in the left ventricle show RBBB morphology in lead V1. Conversely, ventricular complexes that originate in the right ventricle show LBBB morphology in lead V1.”  You can also bite into some of that proverbial “meat” of ECG knowledge.

How about that!