ECG
The correct rhythm is:
1. VT
2. AF with LBBB
3 Hyperkalemia
4. Atrial flutter ( 2:1 conjuction) with LBBB
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Probably atrial flutter with 2:1 AV conduction and underlying LBBB.
We could see atrial activity after QRS complex in lead II (negative morphology) and another one just at the beginning of the QRS complex in lead V2.
QRS complex morphology in leads V5/V6 is not consistent with typical LBBB but could be related to leads position on the chest in relation to the heart.
Baseline EKG?
Carotid massage/adenosine would be helpful to slow AV conduction and reveal underlying atrial rhythm.
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Great tracing! I donβt think we can conclude on a specific diagnosis based on this EKG alone. Agree with @Mansour Khaddr we need more information.
Nonetheless, if I would guess on one thing, it will be VT. I scribbled the rationale for that on my phone. Please look at attached video.
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Thank you Dr Fathi for elaborate answer!!
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The history is very important to confirm the case alongside the ECG. But I would agree with Dr Fathi and go for VT as the ECG demonstrates wide QRS complex.
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VT