ECG in Congenital Heart Disease
Secundum atrial septal defect
- Rhythm: normal sinus rhythm, increased risk of AF with age
- PR interval: first degree AV block in 6-19%
- QRS axis: 0° to 180°; RAD; LAD in Holt-Oram or LAHB
- QRS Configuration: rSr´ or rsR´ with RBBBi>RBBBc
- Atrial Enlargement: RAE 35%
- Ventricular hypertrophy: Uncommon
- Particularities: "Crochetage" pattern
Ventricular Septal Defect
- Rhythm: normal sinus rhythm, PVCs
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
AV canal defect
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Patent ductus arteriosus
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Pulmonary stenosis
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Aortic coarctation
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Ebstein’s anomaly
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Surgically repaired TOF
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Congenitally corrected TGA
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Complete TGA/intra-atrial baffle
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
UVH with Fontan
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
Dextrocardia
- Rhythm:
- PR interval:
- QRS axis:
- QRS Configuration:
- Atrial Enlargement:
- Ventricular hypertrophy:
- Particularities:
ALCAPA
- Rhythm: NSR
- PR interval: Normal
- QRS axis: Possible LAD
- QRS Configuration: Ant-lat Q waves; possible ant-sept Q waves
- Atrial Enlargement: Possible LAE
- Ventricular hypertrophy: Selective hypertrophy of posterobasal LV
- Particularities: Possible ischemia