Answer - Case of the month (Dec 2011)

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Q: After the first two complexes the QRS complex changes. What could explain this?

A. Axis rotation due to left anterior hemiblock

B. Intermittent pre-exitation

C. Sodium channel blocker infusion

D. Intermittent right bundle branch block

Answer: B. Intermittent pre-exitation. See for more information about pre-exitation.