Abnormal Repolarization, Spot Diagnosis?

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Author(s) A.A.M. Wilde, N.A. Blom
NHJ edition: 2007:03,114
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 boy with a birth weight of 3.030 g was born by caesarean section at 33 weeks of gestation because of bradycardia and severe foetal hydrops. Physical examination at birth showed a hydropic neonate with a heart rate of 70 beats/min. He had cutaneous syndactyly between the fourth and fifth fingers of the left hand. During the first week of life he suffered from polymorphic ventricular arrhythmias for which β- blocker treatment was started and an epicardial pacemaker (VVI) was implanted. An ECG a few weeks later is shown in the figure.

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