An Abnormal ECG?

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Author(s) A.A.M. Wilde
NHJ edition: 2007:12,426
These Rhythm Puzzles have been published in the Netherlands Heart Journal and are reproduced here under the prevailing creative commons license with permission from the publisher, Bohn Stafleu Van Loghum.
The ECG can be enlarged twice by clicking on the image and it's first enlargement
Figure 1

A 47-year-old lady presents with an ‘abnormal ECG’. In her family three daughters suffer from a long-QT syndrome type 2 and the responsible mutation has been identified in her husband and his family. An ECG was taken as part of a routine checkup (figure 1).

Is it abnormal and if so, what would your diagnosis be?

Answer