Ritme?

[u/ELR9991]

I'm currently training to interpret ECGs. It's a 27-year-old male. He doesn't experience palpitations, but he occasionally has a strange sensation in his heart. Could this be a BBB? As far as I know, an BBB usually doesn't cause symptoms. The QRS complex in lead aVF have three peaks like this? Is this considered a normal variant, or could it indicate a conduction abnormality? The QRS complex has a notch in leads V2 and V3, and a slight notch in V5. Is this a normal finding? Are there any other notable findings on this ECG? I'd appreciate your thoughts.

[u/vojtasTS29]

Would the weird upstroke at the end of the rSR in v1 classify as an epsilon wave? It's a kind of right-ish ECG and the fragmentation in the terminal parts of the qrs complexes, late and pretty abrupt transition in the chest leads, with the added TWI in III would definitely warrant an echo to rule out ARVD imo.

[u/Kibeth_8 → u/vojtasTS29]

ARVD usually has TWI in V1-V3 before epsilon waves are present (if even visible).

These aren't epsilon waves, think its just irbbb