Published in:
Open Access 01-12-2024 | Right Bundle Branch Block | Case Report
An interesting electrocardiogram caused by lead reversal
Published in: BMC Cardiovascular Disorders | Issue 1/2024
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Background
During normal sinus rhythm, atrial depolarization is conducted from right atrium to left atrium through Bachmann’s bundle, and a normal P wave axis which is measured on the frontal plane is between 0º and + 75º. The change of P wave polarity is helpful for the analysis of origin point.
Case presentation
We report a patient with negative P wave in lead I. The characteristics of QRS complex in leads V1 to V6 are helpful to preliminarily differential diagnosis. The 12-lead electrocardiogram (ECG) with correct limb leads (right arm-left arm) placement shows sinus rhythm with complete right bundle branch block (RBBB).
Conclusions
The change of P wave polarity as well as characteristics of QRS complex can help identify limb-lead reversals.