Hello, Thank you for your query. The ECG is basically a study of the electrical activity of the heart. The usually follows its pacemaker (the sinus node). Hence sinus rhythm is the normal rhythm. The nerve supply to the heart has different parts. One of those is the left bundle branch that divides into 2 (anterior and posterior). In this situation the anterior one seems to be blocked (it is not conducting as normal) and shows up on the ECG.. This along with poor R-wave progression signifies an underlying heart disease, commonly atherosclerosis of the coronary arteries that. Is affecting the normal function of the heart muscle. Premature ventricular contractions (PVC) can be benign. If however, there are too many (more than 6-10) a minute, it may compromise proper blood flow to vital parts like the brain or kidney. Underlying causes need to be investigated and treated if the PVC becomes symptomatic. (giddiness, black outs, headaches, palpitations, chest discomfort, breathing difficulty). I recommend : - a physician and cardiologist consult - an echocardiogram to check for manual function of the heart. -blood tests (complete blood count, lipid profile, blood glucose panel, cardiac enzymes to check for any heart muscle damage) -an angiography if he has any symptoms suggestive of heart disease. He needs a full work up of cardiovascular status and good control of blood glucose levels. Warning signs are unexplained sweating, dizziness, sudden indigestion problems,chest discomfort, reduced urine, swelling of ankles or face. If any of these occur, he should go To the ER right away. Hope this helps. Please let me know if there is anything else I can help you with. Wish you both good health.