My rabbit hole for today is QRS Duration.
Can people here offer an opinion on what the QRS durations are for the tracings above?
The "paper settings" are 10 and 25.
This came from my Wellue 24-hour monitor.
I am thinking that Q is rather hard to nail down. I have read that Q is the first downward deflection after P, but to me -- especially with regard to top row, third from left -- Q could be in two or three places.
Here's a larger image that's on my ftp site:
The QRS duration is measured starting at the end of the PR interval. Normal duration is 0.06 to 0.12 seconds which is 1.5 to 3 small boxes. It’s hard to see where the end of your PR interval is precisely as the tracing isn’t clear (you say tracings plural, but I can only see 1 image?). You have a lot of artefact or movement.
This is a wide QRS and I’ve marked out (clumsily on a phone) and where I understand it is measured from - ie the end of the PR (my visual of the end) to the end of the QRS. It’s much clearer than yours.
The QRS complex represents the electrical activity that causes the simultaneous contraction of the left and right ventricles. If you look at my example, the sawtooth pattern indicates clearly a delay specific to the left ventricle, but not really a delay after the atria.
To explain my comment above: The P wave shows the atria contracting, and the QRS shows ventricles. As the ventricles are ‘meatier’ any delay between them contracting individually is noticeable. But to my understanding, a wide QRS is not just based on the ventricle timing but also the time between atria and ventricle contractions.
I know that’s probably not much help to you specially to your query, but I’m not sure anyone on here has the medical background to give you any real definite answer on it being wide or not based on your images.
Interesting trace. Was this stick-on electrodes or chest strap, and where were the electrodes of either actually located?
"Interesting," huh?
It was with the stick-on electrodes.
They were placed above my breasts, angling down at a 45-degree angle from a bit above my sternum toward my left.
I prefer this form of attachment, because with the straps, the device often resets itself, resulting in five or six separate reports for a 24-hour period, rather than a single page.
As you probably know, a Wellue trace can show 24 hours of heart beats. I am wondering if some of these traces might be useful to my cardio person who seems to be looking for an QRS duration that is too wide.
At this moment, I am having trouble confirming that an EKG from my local GP was faxed last week to the cardio person, who is 100 miles away. So if the EKG was lost (seems to be possible), I'm wondering if I can supply needed info. I know that's for them to say, but if anyone has personal experiences with this, I'd like to hear about them.
Thanks. The Wellue placement leads to some odd traces, and in your trace the reason I say "interesting" is because I can't really identify which way the QRS complex is nor the T wave, and the P wave(?) looks very large. I use much the same positioning with the Wellue but get a large negative deflection within the QRS and can't really see what's what. My P wave is very small and the T wave is clear. ChatGPT reckons I am describing a lead V1 shape.
I put the upper right hand electrode almost up to the sternal notch, near the collar bone, then angle the other 45 degrees down to the left as you describe
The latest: My cardio P.A. (not an MD or EP) told me that because my QRS widening was less than 25 percent, I can continue flecainide. My QRS went up to 116 from 98, which is 19 percent. The dose is 50x2.
I find it difficult to believe that any conclusion can accurately be made from the two pages of tracing that were submitted, but there was a QRSd number that was printed at the side. So I guess she went by that.
Abnormal QRS Pattern 
Kardia showed normal sinus rhythm with wide QRS
Wide QRS interval
Wide QRS with sinus rhythm 
