A 102-year-old woman presents to the emergency department with weakness, fatigue and lethargy.
Describe and interpret her initial 12-lead electrocardiogram:
- Ventricular rate 76 bpm
- Sinus rhythm with 1st degree atrioventricular block (PR interval 262 ms)
- Left axis deviation (-57°) with left anterior fascicular block
- Broad QRS complexes (QRS duration 160 ms) with right bundle branch block
- Voltage criteria for left ventricular hypertrophy (R wave amplitude > 11 mm in aVL)
- QTc 483 ms