title: Differential diagnosis of rSr' pattern in leads V1 -V2. Comprehensive review and proposed algorithm.
abstract: One of the more frequent dilemmas in ECG interpretation is the differential diagnosis of an rSr' pattern in leads V1 -V2 . We often face this finding in asymptomatic and otherwise healthy individuals and the causes may vary from benign nonpathological variants to severe or life-threatening heart diseases, such as Brugada syndrome or arrhythmogenic right ventricular dysplasia. In other cases, a normal variant of rSr' pattern can be misinterpreted as pathological after the occurrence of certain clinical events such as cardiac arrest or syncope of unknown cause. In this review we analyze in detail all the possible conditions, both benign and pathological that may explain the presence of this electrocardiographic pattern. We also propose a simple electrocardiographic algorithm for differential diagnosis.
authors.affiliation: Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
authors.forename: Adrian
authors.initials: A
authors.lastname: Baranchuk
authors.forename: Andres
authors.initials: A
authors.lastname: Enriquez
authors.forename: Javier
authors.initials: J
authors.lastname: García-Niebla
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayés-Genís
authors.forename: Roger
authors.initials: R
authors.lastname: Villuendas
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayés de Luna
mesh_terms: D000465:Algorithms; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods*; D004566:Electrodes; D005660:Funnel Chest / Q000503:physiopathology*; D006321:Heart / Q000502:physiology* / Q000503:physiopathology; D006331:Heart Diseases / Q000503:physiopathology*; D006801:Humans; D006947:Hyperkalemia / Q000503:physiopathology*
keywords: ARVD; Brugada ECG pattern; algorithm; rSr’ pattern