March 21, 2023

T W memory in LBBB-aberrancy


What is your  ECG dx? 

Remastered using @PMCardio App


Image 1 - Image case


A-SR/SB, dextrocardia

B-SR/SB, anterior wall ischemia

C-SR/SB, intermittent WPW pattern

D-SR/SB, LBBB-aberrancy, TW memory, poss lead reversal




Image 2 - Image case annotated

This is sinus rhythm, sinus bradycardia  (~50's). 

Possible LA/RA lead reversal as manifested by - PQRS lead I and + PQRST aVR

At a ventricular rate of ~60 bpm there is left bundle branch block morphology (red box) and a narrow QRS morphology at rates below that. This is LBBB-aberrancy likely rate-related.

The precordial T wave inversion (blue arrows) follows the R wave morphology in LBBB. This is called T wave memory or Chatterjee phenomenon.

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