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QRS complex

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is the J-point. The J-point is easy to identify when the ST segment is horizontal and forms a sharp angle with the last part of the QRS complex. However, when the ST segment is sloped or the QRS complex is wide, the two features do not form a sharp angle and the location of the J-point is less clear.
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Not every QRS complex contains a Q wave, an R wave, and an S wave. By convention, any combination of these waves can be referred to as a QRS complex. However, correct interpretation of difficult ECGs requires exact labeling of the various waves. Some authors use lowercase and capital letters,
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R-peak time for right ventricle is measured from leads V1 or V2, where upper range of normal is 35 ms. R wave peak time for left ventricle is measured from lead V5 or V6 and 45 ms is the upper range of normal. R wave peak time is considered to be prolonged if it's more than 45 ms.
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depending on the relative size of each wave. For example, an Rs complex would be positively deflected, while an rS complex would be negatively deflected. If both complexes were labeled RS, it would be impossible to appreciate this distinction without viewing the actual ECG.
525:(called "delayed transition"). In biomedical engineering, the maximum amplitude in the R wave is usually called "R peak amplitude", or just "R peak". Accurate R peak detection is essential in signal processing equipment for 1334:
Kim SH, Kim CH, Savastyuk E, Kochiev T, Kim HS, Kim TS (2009). "Windowed Nonlinear Energy Operator-based First-arrival Pulse Detection for Ultrasound Transmission Computed Tomography". In Lim CT, Hong JG (eds.).
90:; in children it may be shorter. The Q, R, and S waves occur in rapid succession, do not all appear in all leads, and reflect a single event and thus are usually considered together. A 650:
Monomorphic refers to all QRS waves in a single lead being similar in shape. Polymorphic means that the QRS change from complex to complex. These terms are used in the description of
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Ventricles contain more muscle mass than the atria. Therefore, the QRS complex is considerably larger than the P wave. The QRS complex is often used to determine the
180:, there can be an abnormal second upward deflection within the QRS complex. In this case, such a second upward deflection is referred to as R′ (pronounced "R 1395:
Singh HR, Sharma R, Sahgal N, Sethi P, Kushwah R, Kachhawa P (2010). "An improved method of measurement of ECG parameters for online medical diagnosis".
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Emrich, Jonas; Koka, Taulant; Wirth, Sebastian; Muma, Michael (2023-09-04). "Accelerated Sample-Accurate R-Peak Detectors Based on Visibility Graphs".
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R wave peak time (RWPT) represents the time from the onset of QRS complex to the peak of R wave, which is usually measured in aVL and V5 or V6 leads.
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Diagram showing how the polarity of the QRS complex in leads I, II, and III can be used to estimate the heart's electrical axis in the frontal plane.
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is where the QRS complex changes from predominantly negative to predominantly positive (R/S ratio becoming >1), and this usually occurs at V
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with an increasing R and a decreasing S wave when moving toward the left side. There is usually a qR-type of complex in V
446:. For this reason, they are referred to as septal Q waves and can be appreciated in the lateral leads I, aVL, V5 and V6. 1855: 1833: 404: 96: 2095: 1840: 986: 1921: 617:
There is no consensus on the precise location of the J-point in these circumstances. Two possible definitions are:
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ECG Signal Processing, Classification and Interpretation: A Comprehensive Framework of Computational Intelligence
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in amplitude. However, diagnosis requires the presence of this pattern in more than one corresponding lead.
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2022 44th Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC)
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ThinkQuest 2010: Proceedings of the First International Conference on Contours of Computing Technology
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Looking at the precordial leads, the R wave usually progresses from showing an rS-type complex in V
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Compendium for interpretation of ECG at Uppsala Institution for Clinical Physiology. Year 2010
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Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. (August 2013).
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have been introduced, enabling fast and sample-precise R-peak annotation even in noisy ECG.
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of the electrocardiogram, although it is also possible to determine a separate P wave axis.
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is 0.08 to 0.10 seconds. When the duration is longer it is considered a wide QRS complex.
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Köhler BU, Hennig C, Orglmeister R (2002). "The principles of software QRS detection".
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Pathologic Q waves occur when the electrical signal passes through stunned or scarred
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PĂ©rez-Riera AR, de Abreu LC, Barbosa-Barros R, Nikus KC, Baranchuk A (January 2016).
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of the QRS complex may be useful for detection of coronary artery disease during an
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The duration, amplitude, and morphology of the QRS complex are useful in diagnosing
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Loyola University Chicago Stritch School of Medicine. > EKG Interpretive skills
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Any abnormality of conduction takes longer and causes "widened" QRS complexes. In
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and/or presence of a reversed R wave progression, which is defined as R in V
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Electrocardiogram waveform representing ventricular contraction in the heart
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is the combination of three of the graphical deflections seen on a typical
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Pan J, Tompkins WJ (March 1985). "A real-time QRS detection algorithm".
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The point at which the ECG trace becomes more horizontal than vertical
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Large amplitude might indicate of left ventricular hypertrophy
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of the heart and contraction of the large ventricular muscles.
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Normal Q waves, when present, represent depolarization of the
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The "first point of inflection of the upstroke of the S wave"
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Innovations in Computing Sciences and Software Engineering
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2023 31st European Signal Processing Conference (EUSIPCO)
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A common algorithm used for QRS complex detection is the
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13th International Conference on Biomedical Engineering
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follows the S wave, and in some cases, an additional
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is any downward deflection immediately following the
815:"Complementary and Alternative Medicine Index (CAM)" 2081: 2031: 1998: 1984: 1964: 1901: 1803: 1747: 1699: 1612: 1603: 704:"QRS Interval - an overview | ScienceDirect Topics" 851: 849: 847: 1432:IEEE Engineering in Medicine and Biology Magazine 980: 978: 976: 108:is any downward deflection after the R wave. The 529:measurement and it is the main feature used for 453:; as such, they are usually markers of previous 184:"). This would be described as an RSR′ pattern. 666:algorithm (or method); another is based on the 517:. It is normal to have the transition zone at V 296:S amplitude in V1 + R amplitude in V5 < 3.5 1019:Szczepaniak PS, Lisboa PJ, Kacprzyk J (2000). 1581: 1150: 1148: 485:with the R-wave amplitude usually taller in V 381:Abnormality indicates presence of infarction 8: 1397:Studies in Health Technology and Informatics 1368:Chaudhuri S, Pawar TD, Duttagupta S (2009). 1248:IEEE Transactions on Bio-Medical Engineering 1197:"PSTF Paramedic Student Electrocardiography" 236:Schematic representation of the QRS complex. 1473:Koka, Taulant; Muma, Michael (2022-07-11). 371:Amplitude less than 1/3 QRS amplitude (R+S) 1995: 1609: 1588: 1574: 1566: 1481:. Vol. 2022. IEEE. pp. 121–126. 612:The point where the QRS complex meets the 408:Duration longer than 45 ms might indicate 83:In adults, the QRS complex normally lasts 37:"QRS" redirects here. For other uses, see 1403:(Medical and Care Compunetics 6): 40–46. 1172: 1161:The Western Journal of Emergency Medicine 881: 834: 832: 830: 828: 800: 798: 796: 794: 792: 790: 744: 396:Right ventricle: lead V1 or V2 < 35 ms 145:Electrical conduction system of the heart 104:follows as an upward deflection, and the 1155:Brownfield J, Herbert M (January 2008). 770:"III. Characteristics of the Normal ECG" 637:Various QRS complexes with nomenclature. 393:Left ventricle: lead V5 or V6 < 45 ms 239: 1597:Physiology of the cardiovascular system 862:Annals of Noninvasive Electrocardiology 695: 592:, or a faulty ECG recording technique. 153:occurs almost simultaneously, via the 774:University of Utah School of Medicine 48:Schematic representation of a normal 7: 1297:. Springer. pp. 461–466 (462). 957:"Left Ventricular Hypertrophy (LVH)" 907:"Left Ventricular Hypertrophy (LVH)" 521:(called "early transition") and at V 352:Measured in increased QRS amplitude 1538:10.23919/eusipco58844.2023.10290007 1371:Ambulation Analysis in Wearable ECG 1127:Cadogan M, Buttner R (2020-10-01). 930:Cadogan M, Buttner R (2020-10-01). 576:is commonly attributed to anterior 403:Large amplitude might indicate of 368:ms in leads other than III and aVR 272:Prolonged duration could indicate 25: 955:Burns E, Buttner R (2018-08-01). 905:Burns E, Buttner R (2018-08-01). 374:Amplitude less than 1/4 of R wave 278:intraventricular conduction delay 1293:. In Sobh T, Elleithy K (eds.). 30:For other uses of "S wave", see 580:, but it may also be caused by 572:, or any combination of these. 410:left posterior fascicular block 1487:10.1109/embc48229.2022.9871266 586:Wolff–Parkinson–White syndrome 317:Increased amplitude indicates 310:R in V5 or V6 < 2.6 mV 70:electrocardiogram (ECG or EKG) 1: 1724:Aortic valve area calculation 1345:10.1007/978-3-540-92841-6_115 1133:Life in the Fast Lane • LITFL 994:Journal of Insurance Medicine 961:Life in the Fast Lane • LITFL 936:Life in the Fast Lane • LITFL 911:Life in the Fast Lane • LITFL 1532:. IEEE. pp. 1090–1094. 1409:10.3233/978-1-60750-565-5-40 1311:10.1007/978-90-481-9112-3_78 1221:Sutin KM, Marino PL (2007). 746:10.1161/CIR.0b013e31829b5b44 405:left ventricular hypertrophy 214:, and other disease states. 149:Depolarization of the heart 1841:Effective refractory period 1720:) / End-diastolic dimension 1100:Yoo HJ, van Hoof C (2010). 1046:Gacek A, Pedrycz W (2011). 841:Retrieved on April 22, 2010 127:start at the end of the PR 2201: 646:Monomorphic or polymorphic 461:(40 ms) in width and 142: 36: 29: 2180:Cardiac electrophysiology 2126:Tubuloglomerular feedback 2073:Critical closing pressure 1893:Hexaxial reference system 1816:Cardiac electrophysiology 1106:. Springer. p. 197. 1052:. Springer. p. 108. 1025:. Springer. p. 256. 1022:Fuzzy Systems in Medicine 987:"Poor R-wave progression" 2101:Renin–angiotensin system 1374:. Springer. p. 67. 1260:10.1109/TBME.1985.325532 582:left bundle branch block 212:electrolyte derangements 200:conduction abnormalities 2131:Cerebral autoregulation 2096:Kinin–kallikrein system 2063:Jugular venous pressure 1713:End-diastolic dimension 1691:Pressure volume diagram 1129:"R Wave Peak Time RWPT" 1079:. Springer. p. 8. 932:"R Wave Peak Time RWPT" 652:ventricular tachycardia 590:ventricular hypertrophy 574:Poor R wave progression 538:poor R wave progression 444:interventricular septum 218:High frequency analysis 204:ventricular hypertrophy 2068:Portal venous pressure 2058:Mean arterial pressure 1972:Ventricular remodeling 1718:End-systolic dimension 1676:Cardiac function curve 638: 455:myocardial infarctions 252:Clinical significance 237: 76:of the right and left 61: 53: 2185:Diagnostic cardiology 1709:Fractional shortening 708:www.sciencedirect.com 636: 578:myocardial infarction 235: 208:myocardial infarction 172:Clinical significance 59: 47: 1649:End-diastolic volume 1103:Bio-Medical CMOS ICs 985:MacKenzie R (2005). 821:on 4 September 2009. 222:exercise stress test 120:follows the T wave. 39:QRS (disambiguation) 2013:Vascular resistance 1851:Electrocardiography 1846:Pacemaker potential 1776:Conduction velocity 1681:Venous return curve 1654:End-systolic volume 1303:2010iics.book..461N 319:cardiac hypertrophy 282:bundle branch block 269:Shorter in children 196:cardiac arrhythmias 178:bundle branch block 2121:Myogenic mechanism 1739:Left atrial volume 1671:Frank–Starling law 874:10.1111/anec.12323 639: 536:The definition of 469:R wave progression 238: 62: 54: 2167: 2166: 2163: 2162: 1980: 1979: 1820:Action potential 1811:Conduction system 1757:Cardiac pacemaker 1729:Ejection fraction 1547:978-9-4645-9360-0 1496:978-1-7281-2782-8 1444:10.1109/51.993193 1381:978-1-4419-0725-7 1354:978-3-540-92840-9 1320:978-90-481-9111-6 1232:978-0-7817-4802-5 1113:978-1-4419-6596-7 1086:978-81-8489-988-7 1059:978-0-85729-867-6 1032:978-3-7908-1263-3 684:Electrophysiology 672:visibility graphs 668:Hilbert transform 588:, right and left 435: 434: 364:Duration up to 40 16:(Redirected from 2192: 2106:Vasoconstrictors 2083:Regulation of BP 1996: 1929:pulmonary artery 1902:Chamber pressure 1610: 1590: 1583: 1576: 1567: 1560: 1559: 1523: 1517: 1516: 1470: 1464: 1463: 1427: 1421: 1420: 1392: 1386: 1385: 1365: 1359: 1358: 1331: 1325: 1324: 1289:Nair MA (2010). 1286: 1280: 1279: 1243: 1237: 1236: 1218: 1212: 1211: 1209: 1208: 1199:. 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Archived from 811: 805: 802: 785: 784: 782: 780: 765: 759: 758: 748: 724: 718: 717: 715: 714: 700: 596:R wave peak time 464: 460: 367: 344: 338: 307:< 4.5 mV 265: 240: 167: 89: 21: 2200: 2199: 2195: 2194: 2193: 2191: 2190: 2189: 2170: 2169: 2168: 2159: 2077: 2027: 1989: 1986:Vascular system 1976: 1960: 1897: 1799: 1784:(Contractility) 1743: 1695: 1686:Wiggers diagram 1599: 1594: 1564: 1563: 1548: 1525: 1524: 1520: 1497: 1472: 1471: 1467: 1429: 1428: 1424: 1394: 1393: 1389: 1382: 1367: 1366: 1362: 1355: 1333: 1332: 1328: 1321: 1288: 1287: 1283: 1245: 1244: 1240: 1233: 1220: 1219: 1215: 1206: 1204: 1195: 1194: 1190: 1154: 1153: 1146: 1137: 1135: 1126: 1125: 1121: 1114: 1099: 1098: 1094: 1087: 1072: 1071: 1067: 1060: 1045: 1044: 1040: 1033: 1018: 1017: 1013: 989: 984: 983: 974: 965: 963: 954: 953: 949: 940: 938: 929: 928: 924: 915: 913: 904: 903: 899: 855: 854: 845: 837: 826: 813: 812: 808: 803: 788: 778: 776: 767: 766: 762: 726: 725: 721: 712: 710: 702: 701: 697: 692: 680: 660: 648: 631: 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Retrieved 1201:the original 1191: 1167:(1): 40–42. 1164: 1160: 1136:. Retrieved 1132: 1122: 1102: 1095: 1075: 1068: 1048: 1041: 1021: 1014: 1000:(1): 58–62. 997: 993: 964:. Retrieved 960: 950: 939:. Retrieved 935: 925: 914:. Retrieved 910: 900: 868:(1): 10–19. 865: 861: 819:the original 809: 777:. Retrieved 773: 763: 736: 732: 722: 711:. Retrieved 707: 698: 664:Pan-Tompkins 661: 649: 640: 611: 602: 599: 573: 537: 535: 506: 472: 451:heart muscle 448: 441: 422: 407: 386: 357: 326:Ventricular 325: 289: 274:hyperkalemia 258:QRS duration 257: 246:Normal value 216: 193: 186: 175: 148: 132: 128: 125:QRS interval 124: 122: 115: 109: 105: 101: 95: 91: 82: 65: 63: 50:sinus rhythm 2153:Glomus cell 2143:Aortic body 2138:Paraganglia 1949:ventricular 1922:ventricular 1871:QT interval 1866:QRS complex 1861:PR interval 1834:ventricular 1772:Dromotropic 733:Circulation 629:Terminology 568:< R in V 560:< R in V 552:< R in V 533:detection. 459:> 0.04 s 339:in V5 or V6 328:activation 66:QRS complex 2174:Categories 2091:Baroreflex 2008:Compliance 2000:Blood flow 1876:ST segment 1804:Conduction 1794:Lusitropic 1766:Heart rate 1749:Heart rate 1701:Ultrasound 1632:Heart rate 1207:2010-03-27 1138:2022-01-17 966:2022-01-17 941:2022-01-17 916:2022-01-17 713:2022-08-05 690:References 658:Algorithms 614:ST segment 531:arrhythmia 527:heart rate 343:< 30 ms 337:< 50 ms 330:time (VAT) 228:Components 163:80 to 110 151:ventricles 143:See also: 85:80 to 100 78:ventricles 52:ECG wave. 2051:Diastolic 2023:Perfusion 1782:Inotropic 1661:Afterload 1556:264882655 1513:252165794 564:or R in V 556:or R in V 489:than in V 463:> 2 mm 412:, LVH or 303:R+S in a 298:millivolt 262:75 to 105 243:Parameter 139:Formation 2046:Systolic 1824:cardiac 1505:36086455 1460:11337745 1452:11935987 1417:20543337 1276:14260358 1183:19561701 1006:15895699 892:26523751 779:14 April 755:23877260 678:See also 280:such as 133:interval 129:interval 1666:Preload 1299:Bibcode 1268:3997178 1174:2672223 883:6931847 608:J-point 438:Q wave 1956:Aortic 1944:atrial 1917:atrial 1913:Right 1886:U wave 1881:T wave 1856:P wave 1829:atrial 1554:  1544:  1511:  1503:  1493:  1458:  1450:  1415:  1378:  1351:  1317:  1274:  1266:  1229:  1181:  1171:  1110:  1083:  1056:  1029:  1004:  890:  880:  753:  505:. The 423:S wave 387:R wave 366:  358:Q wave 264:  117:U wave 111:T wave 106:S wave 102:R wave 97:P wave 92:Q wave 32:S wave 18:R-wave 2018:Pulse 1965:Other 1940:Left 1934:wedge 1605:Heart 1552:S2CID 1509:S2CID 1456:S2CID 1272:S2CID 990:(PDF) 501:and V 481:and V 345:in V1 182:prime 100:. An 1542:ISBN 1501:PMID 1491:ISBN 1448:PMID 1413:PMID 1376:ISBN 1349:ISBN 1315:ISBN 1264:PMID 1227:ISBN 1179:PMID 1108:ISBN 1081:ISBN 1054:ISBN 1027:ISBN 1002:PMID 888:PMID 781:2010 751:PMID 544:or V 513:or V 414:LBBB 300:(mV) 189:axis 157:and 64:The 1711:= ( 1534:doi 1483:doi 1440:doi 1405:doi 1401:156 1341:doi 1307:doi 1256:doi 1169:PMC 878:PMC 870:doi 741:doi 737:128 276:or 2176:: 1550:. 1540:. 1507:. 1499:. 1489:. 1477:. 1454:. 1446:. 1436:21 1434:. 1411:. 1399:. 1347:. 1313:. 1305:. 1270:. 1262:. 1252:32 1250:. 1177:. 1163:. 1159:. 1147:^ 1131:. 998:37 996:. 992:. 975:^ 959:. 934:. 909:. 886:. 876:. 866:21 864:. 860:. 846:^ 827:^ 789:^ 772:. 749:. 735:. 731:. 706:. 654:. 584:, 483:6, 416:. 284:. 266:ms 224:. 210:, 206:, 202:, 198:, 168:. 165:ms 87:ms 1988:/ 1778:) 1774:( 1768:) 1764:( 1589:e 1582:t 1575:v 1558:. 1536:: 1515:. 1485:: 1462:. 1442:: 1419:. 1407:: 1384:. 1357:. 1343:: 1323:. 1309:: 1301:: 1278:. 1258:: 1235:. 1210:. 1185:. 1165:9 1141:. 1116:. 1089:. 1062:. 1035:. 1008:. 969:. 944:. 919:. 894:. 872:: 783:. 757:. 743:: 716:. 570:1 566:2 562:2 558:3 554:3 550:4 546:4 542:3 523:5 519:2 515:4 511:3 503:6 499:5 495:1 491:6 487:5 479:5 475:1 41:. 34:. 20:)

Index

R-wave
S wave
QRS (disambiguation)

sinus rhythm

electrocardiogram (ECG or EKG)
depolarization
ventricles
ms
P wave
T wave
U wave
Electrical conduction system of the heart
ventricles
bundle of His
Purkinje fibers
ms
bundle branch block
prime
axis
cardiac arrhythmias
conduction abnormalities
ventricular hypertrophy
myocardial infarction
electrolyte derangements
High frequency analysis
exercise stress test

hyperkalemia

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