Hi, Sinus rhythm with marked sinus arrhythmia and right atrial enlargement suggests that there may be underlying cardiac issues that are affecting the normal electrical activity of the heart. The presence of an RSR or QR pattern in V1 may indicate right ventricular conduction delay, which could be due to a number of reasons, such as a structural heart disease, pulmonary hypertension, or conduction system disease. The borderline ventricular rate of 88 bpm suggests that the heart is beating slightly faster than normal but still within a range that is considered to be normal. The PR interval of 164 ms indicates that the electrical impulse that travels through the atria to the ventricles is delayed. The QRS duration of 80 ms is within normal limits, which means that the electrical impulse is being conducted normally through the ventricles. The QTc interval of 387 ms is slightly prolonged, which could be due to electrolyte imbalances or certain medications. The P wave axis of 72 82 54 suggests that the electrical activity of the heart is originating from the superior and inferior regions of the atria, which is a normal finding. Overall, this ECG suggests the presence of right ventricular conduction delay, which may require further evaluation by a cardiologist to identify the underlying cause and determine if any treatment is necessary. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Diwashish Biswas, Internal Medicine Specialist