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What does QRSD 126, QT 400 and ECG 444 signify?

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Cardiologist, Interventional
Practicing since : 1996
Answered : 192 Questions
what does it mean?

PR 148 Left Axis Deviation
QRSD 126 Left Bundle Branch Block
QT 400 Abnormal ECG
QTc 444 Compared to ECG 01/06/2010
No significant changes

Posted Mon, 30 Apr 2012 in Hypertension and Heart Disease
Answered by Dr. Raja Sekhar Varma 20 hours later

Thanks for your query.

You have sent some of the parameters of your ECG recording. Accordingly,

PR interval is the time from the onset of the P wave till the beginning of the QRS complex. 148 milliseconds is a normal value (120 - 200 ms is the usual range). The QT and QTc (QT corrected for the heart rate) are normal. QT is the electrical relaxation of the heart.

QRSD stands for the duration of the QRS complex and a value of 126 is a little high. This is because of the presence of LBBB or left bundle branch block. This means that the electrical impulse is not getting conducted through its normal path to the muscles of the left side of the heart. The specialized electrical conduction path to the ventricles of the heart branches into two - the left bundle branch and the right bundle branch. It is the left bundle branch that supplies a large part of the left ventricle especially the parts located to the left and laterally. When conduction along this path is blocked or delayed, the electrical impulse reaches these areas directly through the muscle. This is much slower and hence the QRS complex becomes wider (reflecting the increased time taken for the electrical impulse to reach all parts of the heart muscle).

There are many causes of LBBB. Rarely, it may be seen as a normal variant. More often, it is due to age-related degeneration of the conducting system or damage due to ischemia, infarction, inflammation, abnormal electrolytes, etc.

Since it is noted that there are no new changes compared to the previous ECG, it means that the current findings are not new changes but were there in your previous ECG too.

When LBBB is seen in the ECG, it is usual to do an echocardiogram and see the effect on the pumping efficiency of the heart, as also to see if there are any structural problems with the heart. It is also usual to correlate the ECG with the clinical parameters before coming to any conclusion.

Treatment would depend on the cause of LBBB and the other clinical parameters. If the heart is structurally normal with normal LV function, only follow-up is required. If there is any evidence of ischemia, coronary angiogram may be needed. If the pumping of the heart has been significantly reduced and if there are no other reversible causes, a special type of pacemaker treatment called cardiac resynchronization therapy may be helpful in selected cases. Rarely, patients with LBBB may progress to complete heart block with slowing of the effective heart rate, in which case, a permanent pacemaker implantation may be needed.

Hope this answer clarifies your query. Feel free to get back to me for any further doubts.

Dr RS Varma
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