This ECG, kindly donated by Dr. Ahmed from India, is from a 70-year-old man shows a sinus rhythm at 80 bpm with left bundle branch block (LBBB), left atrial enlargement (LAE), and a premature ventricular contraction (PVC). The ECG criteria for LBBB is: 1) Wide QRS - greater than or equal to .12 seconds; 2) Supraventricular rhythm; 3) QRS that is negative in V1 and positive in Leads I and V6. In leads with a positive QRS, we will see some ST depression, and in leads with a negative QRS, some ST elevation.
Left atrial enlargement
Patient's clinical data: 47-year-old black man. Another serial ECG (seen below) showed a supraventricular tachycardia (SVT) at a rate of 164/min that was diagnosed by an Electrophysiologist as atrioventricular nodal reentrant tachycardia (AVNRT). How does knowing the mechanism of AVNRT help you in determining the nature of the mechanism in this week's ECG.
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