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What Does This 12-lead ECG Report Indicate?
Question: My 12 lead report from cardiologist said first degree av block prior to starting bisoprolol. Is this a potential cause of paroxysmal af. He also wrote that I have LAD. Lead Ii is positive and III and avf negative. Surely when lead II is positive this is not LAD or is this physiologic LAD. Thoughts appreciated. Thanks
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and I would like to explain that first degree AV block is not considered a direct cause of paroxysmal atrial fibrillation.
Using a beta-blocker (like Bisoprolol), isn't an absolute contraindication in the presence of first degree AV block. Just a careful follow up is necessary.
Regarding LAD, probably the doctor has mentioned a possible LAD (left anterior descending coronary artery) ischemic lesion, which is usually seen on precordial ECG leads (V1-V6). if you don't have any obvious clinical symptomatology (chest pain, shortness of breathing, etc.), and no suggestive ECG changes on the precordial leads, we can't conclude for any ischemic myocardial disorders in the territory supplied by LAD.
ECG repolarization abnormalities seen on DIII, aVF signify possible ECG ischemic signs of inferior LV territory. Nevertheless, a differential diagnosis is necessary and a clinical correlation as well.
Do you have experienced chest pain, dyspnea, palpitations, etc. recently, on physical exertion, or at rest?
Do you have coronary risk factors, like diabetes, hypertension, dyslipidemia, smoking contacts, a strong family history for coronary disease?
If nothing of the above is present, then there is a low probability of any recent myocardial ischemia disorders.
Nevertheless, it is necessary to review your full cardiologist report (including performed cardiac exams, as well as other lab tests) for a better review of your actual clinical status.
An ECG record would be helpful for a direct judgment.
Please, could you upload your medical report and the attaching ECG??
I am at your disposal for further clarifications.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
I understand your concern, and I would like to explain that first degree AV block is not considered a direct cause of paroxysmal atrial fibrillation.
Using a beta-blocker (like Bisoprolol), isn't an absolute contraindication in the presence of first degree AV block. Just a careful follow up is necessary.
Regarding LAD, probably the doctor has mentioned a possible LAD (left anterior descending coronary artery) ischemic lesion, which is usually seen on precordial ECG leads (V1-V6). if you don't have any obvious clinical symptomatology (chest pain, shortness of breathing, etc.), and no suggestive ECG changes on the precordial leads, we can't conclude for any ischemic myocardial disorders in the territory supplied by LAD.
ECG repolarization abnormalities seen on DIII, aVF signify possible ECG ischemic signs of inferior LV territory. Nevertheless, a differential diagnosis is necessary and a clinical correlation as well.
Do you have experienced chest pain, dyspnea, palpitations, etc. recently, on physical exertion, or at rest?
Do you have coronary risk factors, like diabetes, hypertension, dyslipidemia, smoking contacts, a strong family history for coronary disease?
If nothing of the above is present, then there is a low probability of any recent myocardial ischemia disorders.
Nevertheless, it is necessary to review your full cardiologist report (including performed cardiac exams, as well as other lab tests) for a better review of your actual clinical status.
An ECG record would be helpful for a direct judgment.
Please, could you upload your medical report and the attaching ECG??
I am at your disposal for further clarifications.
Hope to have been helpful!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks. Bisoprolol has made a big difference as I could always feel my heart beat after eating, when stressed, at night etc. have attached 2 parts of ECG. It was def left axis deviation he wrote on report. History as follows - no MI, no chest pain on exertion, history of multiple atrial and ventricular ectopic so for 10 years and self terminating short episodes of paroxysmal af prior to cardioversions where Iv flec ineffective, cholesterol and electrolytes normal, Echo nad, cholesterol normal, no DM or HTN, no fam hx. This ECG shows normal PR but one done by cardiology a week before was extended! Not too sure why it changes? Thx XXXX
Brief Answer:
Everything looks OK!
Detailed Answer:
Hi XXXX!
Your uploaded part of ECG seems quite normal: there is no PR prolongation, no arrhythmia, no repolarization abnormalities on precordial leads, and no AV conductance disturbances.
Regarding your medical history it looks almost OK, besides those episodes of paroxysmal atrial fibrillation. As long as your CHA2DS2-VASc score remains < 2, you don't need anti-coagulation.
Best regards,
Dr. Iliri
Everything looks OK!
Detailed Answer:
Hi XXXX!
Your uploaded part of ECG seems quite normal: there is no PR prolongation, no arrhythmia, no repolarization abnormalities on precordial leads, and no AV conductance disturbances.
Regarding your medical history it looks almost OK, besides those episodes of paroxysmal atrial fibrillation. As long as your CHA2DS2-VASc score remains < 2, you don't need anti-coagulation.
Best regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thx how about ablation? I was offered but said I would wait and see
Will it get worse over time? aF begets AF and all that? Thx for your great replies
Will it get worse over time? aF begets AF and all that? Thx for your great replies
Brief Answer:
Ablation is a therapeutic option.
Detailed Answer:
Yes! It is a therapeutic option. You have to reconsider this possibility, and discuss again with your attending cardiologist. Greetings!
Ablation is a therapeutic option.
Detailed Answer:
Yes! It is a therapeutic option. You have to reconsider this possibility, and discuss again with your attending cardiologist. Greetings!
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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