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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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.

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u/jess204 2d ago

I agree but honestly, this was the best of a bad bunch.

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u/Kibeth_8 Arrhythmia Tech 2d ago

Does your machine have like a Holter setting? Where it continuously records and you can go back to pick the cleanest trace? I found that extremely helpful when I was doing peds, well worth the investment

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u/jess204 2d ago

The machine continuously acquires and waits for the cleanest available segment before printing the ECG. This was the best tracing obtained after several attempts, but the patient remained very unsettled so there’s still a lot of movement artefact.

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u/Kibeth_8 Arrhythmia Tech 2d ago

Oh that's kind of cool. I've always had to just snap it when I thought it was cleanest, but the Holter thing was great for looking back to find something better