ECG interpretation

I'm the owner of a Medtronic Viva XT CRT-D PM
A recent ECG by my EP. Can anyone put these numbers into laymans terms?
Ventricular rate: 98 / Atrial Rate: 98 / QRS Duration: 192
Q-T Interval: 192 / QTCINT: 559 / P Axis: 51
R Axis: -52 / T Axis: 114
DIAGNOSIS: DX:427.31 A-Fib
atrial sensed ventriculal paced complexes
Left axis deviation
Nonspecific intraventricular block

Abnormal ECG
When compared with ECG of 11-Mar 2015 13:56, Sinus rhythm has replaced Electronic ventricular pacemaker.

Thanks for any input!
--Dave--

2 Comments

ECG Interpretation for the Curious

by donr - 2015-07-03 07:07:59

Dave: i took a shot at your last ECG question, so i m,ay as well try this one, also. I'll copy your post & key my answers to your questions.

Ventricular rate: 98 / Atrial Rate: 98
It doesn't specify whether it is PACED % or actual pulse rate, BUT, you said you are only paced in the Ventricles, so I am guessing that it means that the Atria beats at 98 BPM & the Ventricles beat at 98 BPM. It could be a pair of different rates if you were in AFib & the Atria were racing like mad & the Ventricles were plugging along at a slower rate. That CAN happen.

QRS Duration: 192
The QRS Interval is the length of time, measured in milliseconds (1 millisecond =.001 Second). The QRS is the dominant wave shape in the ECG trace. Usually its a small negative blip, followed by a very tall positive blip, followed by another small negative blip. So yours takes 192 milliseconds (ms). Not too shabby. Since you are paced 100% in the Ventricles, you should see a very sharp spike just at the beginning of the Q part of the complex. That is the voltage spike your PM puts out. to make the ventricles contract.

Q-T Interval: 192 / QTCINT: 559
QT interval repeated - 192 ms. The QTCINT probably means what is written by hand as QTc Int meaning "Corrected QT Interval. The QT Interval is the time from the beginning of the Q wave to the END of the T wave, measured in ms. There is another number, the QTc, which is a computed number based on where the T wave would intersect the base line of your ECG. You need to ask your Cardio about this one, it's too complex to explain in writing, but needs a pad & paper to graphically show you what it is.

P Axis: 51 R Axis: -52 / T Axis: 114
These numbers are derived from the 12 leads & the various times of the waves. Not easy to explain, & to us normal humans, have little meaning. To the cardio, however, thay can mean a lot. Ask him what the significance is in your case.

DIAGNOSIS: DX:427.31 A-Fib
You have A-FIB. the DX 427.321 is a medical diagnosis code that ins companies & Medicare use.

atrial sensed ventriculal paced complexes
This says that your Atria function based on output from the SA Node - they are "Sensed." your Ventricles are, OTOH, working from the PM output (Paced).

Left axis deviation
Recall the three axes mentioned above? this says the left one deviates from normal.

Nonspecific intraventricular block
This says you have an AV block

Abnormal ECG
Obviously abnormal - you have pacing going on & some axes are deviated.

When compared with ECG of 11-Mar 2015 13:56, Sinus rhythm has replaced Electronic ventricular pacemaker.
This one makes little sense to me. You know that you only have AV block, so the Atria SHOULD be functioning in sinus rhythm.

Ask your Cardio to confirm that I have it all correct. The QTC & axis numbers are beyond my knowledge base & have a lot of significance to the Cardio community.

Donr

Thanks, donr!

by Dave H - 2015-07-03 10:07:47

Hey! Thanks donr!
--Dave--

You know you're wired when...

Your kids call you Cyborg.

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A pacemaker suddenly quitting is no more likely to happen than you are to be struck by lightening.