59 year old man with a 9 year history of palpitations. Had a recent syncopal episode.

Vent. rate 64 bpm
PR interval 122ms
QSR duration 120ms
QT/QTc 416/429ms
P-R-T axes 49 -2 39


Questions For Thought

What do you think this is?
1: left bundle branch block
2: right bundle branch block
3: true posterior wall MI
4: some other interpretation
Do you think this ECG is helpful in explaining the probable cause of this patient's symptoms?

Answers available here