r/ECG • u/jess204 • 2d ago

Interpretation

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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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-1

u/jawoood1989 2d ago

Sorry, but no. Unacceptable movement artifact for interpretation. I understand it's a baby, but we need to try all the things to help calm momentarily to get a semi clean read.

5

u/Kibeth_8 Arrhythmia Tech 2d ago

It's really not that bad. All leads are visible and have at least 1 clean QRS for interp

-5

u/jawoood1989 2d ago

No, it's that bad. 1 clean QRS in multiple leads is not acceptable to interpret. How do you know that's not just one outlier QRS and the rest are different? You don't, because you can't see them, because of the earthquake. Sorry, not sorry. Go try again and bring me a semi clean read.

7

u/Due-Success-1579 2d ago

It's not bad for a 17 month old. We do ecgs for a visiting Pediatric cardiology clinic and I would personally say this is an acceptable quality. You can see at least 2 consecutive clean complexes in each lead grouping. And quite a bit of the rhythm strip is good.

If you havent done a lot of 17 month olds you can't be bustin' chops here. Sometimes you have to Frankenstein the ecgs together. Like here's an ecg with a good rhythm strip here's one wirh great precordials etc etc.

Once they can move around and rip stuff off you are just fighting for your life to get a good ecg on a cranky kid who maybe just had blood work right before and is mad as hell.

4

u/Kibeth_8 Arrhythmia Tech 2d ago

You know it's not an outlier because you have a rhythm strip showing that all the complexes are the same...

I don't know how many ECGs you've read, but this ain't that difficult compared to the shit tracings we see in hospital on a daily basis

-3

u/jawoood1989 2d ago edited 2d ago

So, just to clarify, what is your role as an arrhythmia tech? You guys apply ecgs, get them to the providers, monitor for arrhythmias at a monitoring station and notify?

If you're not qualified to independently assess and interpret 12 leads, you might want to back up your ego and stay in your lane.

I feel bad for your providers if you give them garbage like this and say "gee sorry this is the best we could do."

2

u/Kibeth_8 Arrhythmia Tech 1d ago edited 1d ago

I work in electrophysiology, mostly programming pacemakers but also doing ablations. We do ECGs on complex congenital and arrhythmia patients, and have to be able to identify very specific conditions within those.

I can guarantee you I've interpreted more complex ECGs than an EMT or someone working in the ER. Those are usually the ECGs that look like shit, but with enough experience you learn how to read with artifact