[Skip to Navigation]
Challenges in Clinical Electrocardiography
November 22, 2021

An Unusual Wide Complex Rhythm—What Is the Diagnosis?

Author Affiliations
  • 1Cardiovascular Institute of the First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning Province, China
  • 2Department of Cardiology of the Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
JAMA Intern Med. 2022;182(1):72-73. doi:10.1001/jamainternmed.2021.6778

A woman in her 80s was referred for a cardiac evaluation after results from an electrocardiogram (ECG) performed during a routine health evaluation showed a wide QRS complex. The patient had no previous medical records with her at the evaluation. An initial 12-lead ECG is shown in the Figure, A.

Questions: On close examination of the admission ECG, what are the unusual findings, and what is the most appropriate next step in the evaluation? How should the ECG be further analyzed?

Add or change institution
×