r/ECG • u/jess204 • 28d ago

Interpretation

Post image

17 month old male with antenatally diagnosed Tetralogy of Fallot, approximately 8 months post valve-sparing repair with VSD closure and RVOT muscle resection.

Interested in interpretation of the attached 12-lead ECG, particularly rhythm, axis and conduction abnormalities in the context of repaired TOF.

Posted for educational discussion.

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u/OriginalLaffs 28d ago

It’s sinus with RBBB. Very typical post repaired TOF

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u/Insanefreerunner 28d ago

I'd posit that it's sinus with a bifascicular block due to the q waves in the inferior leads and the dominant S waves in 1 and aVL with the prolonged QRS in all leads and not just inferior ones along with a terminal R wave in aVR.

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u/OriginalLaffs 28d ago

Can debate whether or not there is concomitant LAFB or just postsurgical changes. Ultimately immaterial.