“First leaf,” she prompted. “The rhythm.”
They gave adenosine. The tachycardia broke. The underlying rhythm was atrial flutter with 2:1 block and rate-related left bundle branch block. The patient sighed, his chest pressure gone, and asked if he could have some water. Shamrock Ecg Book
They measured. Northwest axis—extreme rightward deviation. A murmur went through the room. “First leaf,” she prompted
They looked. The QRS complexes in V1 looked like a rabbit’s ear—left ear taller than the right. In V6, deep S-waves. And then Patel pointed. “There,” she said. “In the middle of the tachycardia. A captured beat. Narrow. Normal-looking.” his chest pressure gone