The R’ or r’ de˛ection is usually wider than the initial R wave. Rhythm is Regular. 그리스 로마 신화 신이자 바다의 신인 넵투누스(Neptunus)로부터 기원했습니다. A regular wide QRS complex tachycardia at 188 bpm with left bundle-branch block morphology, left-superior axis, and precordial transition at lead V6 is shown. 06 – 0. 141 mS. The QRS complex is a portion of the ECG that represents the electrical impulse as it is being distributed by the bundle branch system throughout the ventricles. Figure 2. C. When the limb electrodes (LA, RA, LL) are exchanged without disturbing the neutral electrode. A complete RBBB has a QRS. The numbers are the time inervals. Measure the PR interval . #31. AVNRT for two. The 12-lead ECG features of the QRS complex that define a complete RBBB include adult QRS duration ≥120 ms; an rsr', rsR', or rSR' in the right precordial leads (V1 and V2); S wave of greater duration than R wave or >40 ms in the left lateral leads (I and V6); and normal R peak time in leads V5 and V6 but >50 ms in lead V1. Cardiovascular disease is the first cause of death around the world. 12 s) the impulse must pass through the bundle of His and be delivered to both bundle branches. Neptunus mengelilingi Matahari hanya sekali sejak pertama kali ditemukan pada tahun 1846. Neptune was the Roman god of waters and seas, who controlled winds and storms. 12 s) in duration (three small [40 ms] box widths on standard ECG displays); with incomplete blocks, the QRS interval is defined between 100 (or 110 by computer) and 120 ms (0. CDISC develops SDTMIG (tabulation) and ADaMIG (analysis) QRS supplements that provide information on how to structure the data in a standard format for public domain and copyright-approved instruments. Herein, we will discuss what makes up the electrical axis, ventricular. A QRS complex that cannot be classified as. Bladelius Embla Classic. CMS calculates ratings on a 1-to-5 scale (5 is the highest) each year for eligible QHPs in all. The movement of electrically charged particles – which occurs during the spread of the cardiac action potential – generates an electrical vector. 1–3 Clinical and ECG parameters such as nonsustained ventricular tachycardia, QRS prolongation, left bundle-branch block (LBBB), and the heart rate–adjusted QT interval have been shown to be predictive of cardiovascular. The rule is: if the wave immediately after the P wave is an upward deflection, it is an R wave; if it is a downward deflection, it is a Q wave:I love the way that Holland America has made boarding day as stress free as possible. Electrical impulses that arise above or within the AV node are labeled supraventricular. 1 post published by Jack and Barbara Cummings on February 8, 2019The normal duration of the QRS complex is: 0. 70 bpm. Figure 3 - Determining the Rhythm Source Also look at the quality and quantity of P-waves before each QRS. Background The electrocardiographically quantified QRS duration measures ventricular depolarization and conduction. These may have abnormalities in people with A-fib. Depolarizations are represented by the P-wave (atrial lead) and QRS complex (ventricular lead). A normal heart rhythm contains a P wave, a QRS, and a T wave. PR is the duration of the PR interval. 63 mS. Cuối cùng đưa ra kết quả điện tâm đồ. the pacemaker or pulse generator) and a lead or leads. 1. Figure 1: Calculating heart rate on EKG sheet,. In the remaining 25% of cases, the. Dual Chamber Pacing. wide QRS with a rate of 60-110/min. 12 seconds; Broad monomorphic R waves in I, aVL, V5, and V6. First described in 1930 by Louis Wolff, John Parkinson and Paul Dudley White. . It is a tool used to visualize, or “gram,” the electricity, or “electro,” that flows through the heart, or “cardio. É a morfologia típica da derivação V3. Am Heart J. Các giá trị cho thấy kết quả điện tâm đồ gồm có: nhịp tim, tần số, đoạn PR (Q) và vấn đề dẫn truyền, trục điện tim QRS, mô tả sóng P, mô tả phức bộ QRS, mô tả đoạn ST và T, mô tả bất thường về rối loạn nhịp nếu có. The concept is that with aberration, ventricular activation during the first portion of the QRS is mediated by the His-Purkinje system, whereas in VT, the His-Purkinje system is engaged later in the QRS complex. For management, see “Management of Wide Complex Tachycardia”. Paikalla käveli huomiota vältelleen myös laitteiden isä Michael Bladelius joka ennen Ruotsiin palaamistaan työskenteli mm. 5 mV) or less in all of the frontal plane leads and 10 mm (1. However, as you can see, the QRS complex is still prominent and visible. Crossref Medline Google Scholar; 26. 63 mS. Eleganta och mycket välbyggda. Before mobile phones and coast-to-coast cell coverage, roadside diners and gas stations did good business selling foldout maps to travelers who passed through town. The QT interval is corrected because it varies depending on the heart rate, so they came up with. Ventricular demand pacing appears on the electrocardiogram (ECG) as a single pacemaker spike followed by a QRS complex that is wide, bizarre, and resembles a ventricular beat ( waveform 2 ). Fascicular ventricular tachycardia is an idiopathic form of VT. Insert an advanced airway. The electrocardiogram (abbreviated as ECG or EKG) represents an electrical tracing of the heart and is recorded non-invasively from the surface of the body. QRS duration should be measured in the lead with the longest QRS duration (which is usually a lead with visible Q-wave). The earliest manifestation of hyperkalaemia is an increase in T wave amplitude. Magnifika. Electrical vectors. 2007. 4,17 QRS duration is a readily available “front-line” clinical indicator of increased risk of SCD. Wide QRS complexes - indicative of a ventricular rhythm, or aberrant conduction of a supraventricular rhythm. Round your answer to the nearest whole number. This is known as the rule of proportionality. Confirm or corroborate any findings in this lead by checking the other leads. In 2011 Neptune completed its first 165-year orbit since its discovery in 1846. Audiostatic is very claear and bright - you can listen every micro detail in space. often causes haemodynamic compromise c/o loss of atrial systole. In lead 2 there was a possible sinus capture beat. Smith’s ECG Blog. (See "Modes of cardiac pacing: Nomenclature and selection". The simplest way to assess the source is to look at the width of the QRS complex. Plausibly, the first computerized and automated electrocardiogram (ECG) signal processing algorithm was published in the literature in 1961, and since then, the number of algorithms that have been developed to-date for the detection of the QRS-complexes in ECG signals is countless. The QRS complex refers to the combination of the Q, R, and S waves, and indicates ventricular depolarization and contraction (ventricular systole). The ST segment on an electrocardiogram (ECG) normally represents an electrically neutral area of the complex between ventricular depolarization (QRS complex) and repolarization (T wave). This can be due to an. Junctional bradycardia: < 40 bpm. Sökresultat Sökningen pågår Sökresultaten dyker upp här efterhand. Relatively constant P-P interval despite irregularity of QRS complexes. Northumberland Fire Co. Study with Quizlet and memorize flashcards containing terms like The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. 2. QRS duration must be <0,12 s (normally 0,07-0,10 s). This causes a delayed/slurred initial QRS component. The duration, amplitude, and. The Machine . Weitere Suchvorschläge: qrx-9001 (246). 2004; 93:244–246. A rapid heart rate will significantly reduce the time which the ventricles have to fill. For a craft project, four students each chose three pieces of wire from a box. QRS duration > 120ms. QRS Duration; QT Interval; QRS Axis . Prolonged QRS duration – Because it takes a longer time to depolarize a larger myocardial mass, the QRS duration may be slightly prolonged. This beautiful wreath in the Showroom at Sea was just a taste of the Christmas decorations that adorned our “Home at Sea”. Polymorphic VT has QRS complexes greater than or equal to . The ECG machine is designed to recognise and record any electrical activity within the heart. There is a progressive change in. g. In Chou's Electrocardiography in Clinical Practice (Sixth Edition), 2008. As such, instead of the QRS complexes looking thin and normal, they are wide and bizarre-looking, just like premature ventricular complexes. In normal sinus rhythm, a resting heart rate of below 60 bpm is called bradycardia and a rate of above 90 bpm is called tachycardia. The charge time and maximum tears per charge scale with Isaac's tears stat, with higher tears charging faster and having more. Use the level argument to specify a confidence level between 0 and 1. 3. In this mobile era, threshold algorithm can be. Antidromic Tachycardia: The stimulus is conducted from the atria to the ventricles via the accessory pathway, and returns to the atria via the conduction system. The threshold algorithm of QRS complex detection is known for its high-speed computation and minimized memory storage. aVL shows qR complex. Our bus ride from the hotel took us about 20 minutes and was very comfortable. This prolongation may also be due to myocardial fibrosis which is typical in hypertrophy. Skick: Ny. The appearance of LBBB may cause no QRS axis shift in the frontal plane or variable degrees of left and superior axis shift (Figure 4-2). These are all regularly irregular rhythms. En el electrocardiograma normal se pueden observar en las derivaciones V5 y V6. A QRS duration greater than 140 mseconds favors a diagnosis of VT. anterior, The duration of the QRS complex should be _______ milliseconds or less in a healthy adult. Wolff-Parkinson-White Syndrome. . A six second interval would be 30 large squares. C) jugular venous distention. Deviation of the axis suggests a change in the mean vector of electrical flow within the heart. Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac preexcitation syndrome that arises from abnormal cardiac electrical conduction through an accessory pathway that can result in symptomatic and life-threatening arrhythmias. Values without confidence interval are simply the 98 th percentile (i. Storebror till Saturnus. This bypass tract avoids the atrioventricular node (AVN) permitting premature ventricular. We hypothesized that CHF risk increases with longer QRS interval in individuals free of CHF. The diagnosis is made when clinical symptoms are present together with the typical type 1 Brugada pattern (BrP). QRS Saturnus, Neptunus och supernova. The word ECG derives from the German language. To determine heart rate, count the number of QRS complexes over a 6 second interval, then multiply by 10 (Note: this method works well for both. ³ Knowing the normal amplitude, deflection, and duration of each component is essential to accurate rhythm and EKG/ECG interpretation. He lives in The White Phial store. Holding down the fire button will release all stored tears in rapid succession. RS: onda R alta seguida de onda S profunda, de similar longitud (complejo QRS isobifásico). 12 second when inverted P is before qRs qRs: 0. Evanelpus: 3. g. These complexes are premature atrial complexes (PACs). Indeed, in terms of magnitude of benefit from CRT, the greatest benefit is seen for females, wider QRS, LBBB, and nonischemic cardiomyopathy. On a 12 lead ECG this is usually a 10 second recording from Lead II. If 3 flutter waves occur before each QRS complex then it is 3:1 block. ST-T changes always occur in the presence of LBBB. ) of the QRS are deemed to be owned by the. 498. 04 – 0. T. 15 Right superior (“northwest”) axis is suggestive of VT. The EKG rhythm will appear regular unless atrial fibrillation present. Du kan fortsätta skriva om du vill begränsa sökningen. The interpretation of 12-lead resting ECG in patients with a definitive diagnosis or with the suspicion of a cardiomyopathy represents a cornerstone for the diagnostic work up and management of patients. QRS duration >0. Left bundle branch pacing is a novel pacing modality that can bypass the pathological or disease-vulnerable region in the cardiac conduction system, to provide physiological pacing modality for patients. For the inexperienced, one of the most confusing aspects of ECG reading is the labeling of these waves. 10 sec) and the T wave normal. Normal limits for ECG parameters during neonatal period (Davignon et al) These reference values are the best available for the neonatal period. Refer to Figure 6. Es la morfología típica de la derivación V3. Study with Quizlet and memorize flashcards containing terms like (1) cardiac-related chest pain may be palliated by: (quiz 1) A. Considering the ECG, which is fundamental in all arrhythmias, the first task is to determine whether the arrhythmia is a wide complex tachycardia (WCT) or a narrow complex tachycardia (NCT). Vad jag har fattat så har Saturnus och. QRS complex — Normal axis is between 550 and 2000 at birth — By 1 monthl normal upper limit is < 1600 — May have more notches than in older children/adults — Q wave. Prognostic value of fragmented QRS on admission in non‐ST‐elevation myocardial. In Group 1, it was significantly more common in cases. • Quality Rating System (QRS) Measure Technical Specifications should be followed for all required measures. AV junction ablation should be added in the case of incomplete biventricular pacing (90-95%) due to conducted AF. 2. ECG. Bradyarrhythmias include sinus node dysfunction and atrioventricular block, and are characterized by a resting heart rate 60/minutes. 9. Initiate capnography. The P wave and PR segment is an integral part of an electrocardiogram (ECG). Närbild (2012-09-02 15:33:45) Bilden är högupplöst. Classic Paroxysmal SVT has a narrow QRS complex & has a very regular rhythm. b. 987. QTc is the "corrected" duration of the QT interval. 001) were significantly different between the genotypes, where LQT3-patients had the longest PQ interval (149±30 ms) and QRS duration (87±17 ms). 422 mS. 0 mV) or less in the precordial leads. Remember me Not recommended on shared computers. The pacing wire enters the body through an introducer sheath, and is externally connected to a pulse generator (aka “pacing box”) Epicardial pacing. The three premature complexes are identical in shape – narrow QRS complex and a peaked P wave preceding. In electrocardiography, left axis deviation is a condition where the mean electrical axis of ventricular contraction of the heart lies in a frontal plane direction between −30° and −90°. -8. Normal sinus rhythms have a rate of 60 to 100 beats per minute, the atrial and the ventricular rhythms are regular, the P wave occurs prior to each and every QRS complex, the P waves are uniform in shape, the length of the PR interval is form 0. Exhibit 24. Every P wave is followed by a QRS complex (i. qRs: onda Q inicial pequeña (no patológica), seguida de onda R alta y de onda S pequeña. Sign In. The decision logic considers the rhythmic and. Find local businesses, view maps and get driving directions in Google Maps. Runaway pacemaker (Ortega 2005) Life-threatening malfunction seen in older-generation pacemakers resulting from low battery voltage. 20 seconds) due to delayed conduction via the atrioventricular node. Produkter på bilden: Asus EA-N66, Asus RT-AC66U, Bladelius Embla Classic, Burmester 956 MK2, Canal Digital HD PVR 5720SX, Nintendo Wii U Premium 2012 32GB, QRS Neptunus, Samsung UE65F8005, Synology DiskStation DS214play, Transparent Cable MusicWave Plus 2Banana - 2Banana (par) 2,4m. the major terminal portion of the QRS complex is located on the opposite side of the baseline from the ST segment and T wave. When Isaac is not firing tears, a charge bar will start to fill up. QRS Complex. Figure 38. Examine the QRS complex in each lead and determine if. In the courtyard is a statue honoring Sir Benjamin Lee Guinness Baronet LL D a patron of the Cathedral and Member of Parliament for the City of Dublin, and he made a pretty. QRS wave complex. encountered in an inferior AMI. Inverted, lost, or late P wave before each QRS and T wave. 44%, and an LBBB in 23% vs. 10 sec; QRS amplitude is quite variable from lead to lead and from person to person. Ambulance 208 Race St. List ways to figure heart rate. Supraventricular tachycardia (SVT) is a common cause of hospital admissions and can cause significant patient discomfort and distress. J point in a) normal; b) c) J point elevation; d) J point depression; e) with J wave (Osborn wave) Note: The letter J on the ECG defines 2 totally different and unrelated events. PR interval. The QRS complex of a PVC is widened, often notched, and typically has a QRS duration >0. This ECG is a difficult one! Although there is a broad complex tachycardia (HR > 100, QRS > 120), the appearance in V1 is more suggestive of SVT with aberrancy, given that the the. Pro-Ject Tubebox S & Auralic. QRS appears at about 75, so you can estimate the rate at 75 beats per minute. Although prominent Q waves are a characteristic finding. There is a late transition (persistent S-wave) in the precordial leads. Am Heart J. QT is the duration of the QT interval. The electrical axis of the heart (heart axis). Study with Quizlet and memorize flashcards containing terms like Cardiac monitoring of a patient in cardiac arrest reveals ventricular fibrillation. Liam's wires measure 16 inches, 8 inches. Tomodachi Life codes QRs Mii – League of Legends. Study with Quizlet and memorize flashcards containing terms like The circumflex branch of the left coronary artery supplies the _____________ wall of the left ventricle. Robert Buttner and Ed Burns. This ECG is a difficult one! Although there is a broad complex tachycardia (HR > 100, QRS > 120), the appearance in V1 is more suggestive of SVT with aberrancy, given that the the complexes are not that broad (< 160 ms) and the right rabbit ear is taller than the left. This skewing of one ventricle taking longer than the other widens the QRS. Transvenous pacing. ECG Rhythm Evaluation. nu Päivitetty 16. qRs: onda Q pequena inicial (não-patológica), seguida de uma onda R alta e de uma onda S pequena. When it malfunctions, the issue is with rate, pacing, capturing (i. 12 seconds), and can have either a regular or irregular rhythm. January,February,March,April,May,June,July,August,September,October,November,DecemberMinhembio - Mötesplatsen för hembio och hifi-entusiater. This can be due to an anatomical or functional impairment in. Second-degree AV block is subdivided into type 1 and type 2 (also called Mobitz type 1 and Mobitz type 2, respectively). Neptunus mirip dengan Uranus sehingga kerap disebut planet kembar. This means that that neither the left or right bundle branch conducts the electrical impulse. Jarak rata-rata Planet Neptunus dari Matahari diperkirakan 4. the term electrical axis of the QRS refers to the mean manifest electrical potential in space responsible for this electrocardiographic complex. Implications and causes of wide (broad) QRS complex. Utheemu Ganduvaru is the wooden palace in which Sultan Mohamed Thakurufaanu lived and. If there are 2 flutter waves before each QRS complex then it is 2:1 block. All our ECGs are free to reproduce for educational purposes, provided: The image is credited to litfl. However, all three waves. Left Axis Deviation (LAD):. In the figure above, Panel A shows what a. rS: uma onda R baixa seguida por uma onda. The heart fills during diastole, and diastole is normally 2/3 the cardiac cycle. Ventricular rate of 82/min with an atrial rate of 80/min. 25 mm/s. AV block represents a delay or disturbance in the transmission of an impulse from the atria to the ventricles. The transition from ST segment to T-wave is smooth, and not abrupt. 12 s) or more is required to diagnose a complete left bundle branch block. Study with Quizlet and memorize flashcards containing terms like As the nurse, you know that the following can cause rhythm disorders: A. WPW Syndrome refers to the presence of a congenital accessory pathway (AP) and episodes of tachyarrhythmias. 12 seconds. A P-Wave that is absent or inverted is abnormal. Fire Co. The most common cause is idiopathic fibrosis and sclerosis of the conduction system. 35–0. A recent consensus report on early repolarization (MacFarlane et al, 2016, JACC) stated the following criteria for early repolarization:ECG Library Function. One of the most useful and commonly used diagnostic tools is electrocardiography (EKG) which measures the heart’s electrical activity as waveforms. The Delta wave is a slurred upstroke in the QRS complex. Defibrillation. 12 seconds; Slurred S wave in lead I, aVL, V5, and V6 (Depolarization moving away from these leads) RSR’ in V1 and V2 with R’ > R (Depolarization moving toward these leads) ECG from Dr. e in the Purkinje fibers). Neptunus Rex: 15th Jul 2010 15:33: Can you quote the QR? In my day, (admittedly long ago) hats were only worn indoors at courts martial and funerals. The strip should be made up of 30 large squares. Patients with ischemic and nonischemic cardiomyopathy are at increased risk for sudden cardiac death, and implantable cardioverter-defibrillators (ICDs) reduce this risk. She becomes diaphoretic, and her. This is my fourth post on ‘quantum resonance spectrometry’ (QRS), a strange medical technology that seems to be becoming increasingly popular in China. says. The mECG_QRS and fECG_QRS variables contain QRS peak locations of the maternal and fetal ECG signals and can be used to validate the efficacy of a source separation algorithm to identify correct heartbeat locations in time. The previous slides presented the five-steps of rhythm analysis. Fakta menarik lainnya ialah pada usianya. Margo's wires measure 6 inches, 8 inches, and 14 inches. QRS Complex | Learn the Heart - Healionarrow or wide QRS complexes, depending on its origin. This rapid and irregular electrical activity renders the ventricles unable to contract in a synchronised manner, resulting in immediate loss of cardiac output. Leads V1-V2: The QRS complex appears as the letter “M”. The PQ interval ( P =0. e. No complete. Upon our arrival at the terminal we dutifully waited ten minutes or so while our driver unloaded all our carry-on luggage. Dark, cold, and whipped by supersonic winds, ice giant Neptune is the eighth and most distant planet in our solar system. This example uses the data from the first nine subjects to train a deep network and the data from the tenth subject to test the network. Prolonged QRS duration (QRS duration ≥0. Neptune ( Latin: Neptūnus [nɛpˈtuːnʊs]) is the Roman god of freshwater and the sea [2] in Roman religion. In addition to high-quality CPR, what intervention should be a priority for the team? Select the correct answer to this question. Use this EKG interpretation cheat sheet that summarizes all heart arrhythmias in an easy-to-understand fashion. Narrowing the QRS to normal for the patient or less than 140ms (toxicologists have varied opinions but between 120-140ms is safer than too much sodium bicarbonate) Maximum Sodium of 155 mmol/L. Teksti: Jarmo Aulen Kuvat: Timbre/HifiForum. 9. 5 V, impedance of 750 Ω, and QRS wave width of 98 ms after pacing, which was consistent with the preoperative QRS wave pattern (Fig. Sensing is used to inhibiting or triggering pacing pulses. We evaluated 1759 Framingham Study participants (mean age, 69 years; 63% women) without prior myocardial infarction or CHF who attended a. QRSd is the duration of the QRS interval. Sebagian besar planet mempunyai pengiring atau pengikut yang disebut Satelit yang beredar mengelilingi planet. ECG Diagnostic criteria. then look at it a 2 nd and 3 rd time. Figure 1. Närbild (2012-09-02 15:33:45) Bilden är högupplöst. Pacemaker delivers runs of pacing spikes in excess of 2000 bp. In typical cases of atrial flutter the atrial rate is around 300 beats per minute with a 2:1 block, which yields a ventricular rate of about 150 beats per minute. pH aim of 7. Utheemu, Maldives is famed as the birthplace of Sultan Mohamed Thakurufaanu, who with his brothers and his companions fought an eight-year-long war to drive out the Portuguese invaders who occupied the Maldives from 1558 to 1573. Tomodachi Life codes QRs Mii – Sailor Moon. Prolonged (broad) QRS complex. Sandhu R, Bahler RC. Divide the number 300 by your answer above. defining “sodium channel blockers” The term “sodium channel blocker” is used here solely to refer to agents with either class Ia or class Ic antiarrhythmic activity, which causes a slowing of phase-zero depolarization in cardiomyocytes (purple arrows above). delivering the spike to depolarize the myocardium), or sensing [1]. com QRS Width Normal QRS width is 70-100 ms (a duration of 110 ms is sometimes observed in healthy subjects). Introduction. This calculator is intended for use by health care providers. At birth, the QRS time is <80 ms and then it gradually increases. A 56 year old year old woman presents to the Emergency Department with a referral from her General Practitioner for “ assessment and management of severe tachycardia and possible myocardial infarction ” following a sudden onset of palpitations. 00, you could have made a profit. If heart rate exceeds 100 bpm, then rhythm may be multifocal atrial tachycardia (MAT). P waves: There is a P wave for every QRS complex and a QRS. Temporary cardiac pacing (TCP) is a type of exogenous cardiac pacing in which an external energy source delivers electrical impulses to stimulate the heart to contract faster than its native rate. It will have a morphology that resembles a right or left bundle. 38 – 0. Which findings are considered. Strangely, it is slightly more massive than Uranus, which is strange given that the mass of the gas giants should increase the. A premature atrial contraction occurs when an ectopic focus in the atria discharges before the next sinus impulse. 0 mV) or less in the precordial leads. ECG criteria for right bundle branch block (RBBB) QRS duration ≥0,12 seconds. Calculate the heart rate. 1,2 The presence of AF alone is associated with a higher morbidity and mortality compared with normal sinus rhythm. e totally irregular) ventricular rate. The T-wave should be concordant with the QRS complex, meaning that a net positive QRS complex should be followed by a positive T-wave, and vice versa (Figure 17). In case of chest pain, the level of ST segment elevation is measured in J termination. QRS duration ≥120 ms 2. Selain itu, atmosfer Neptunus juga terdiri dari metana, amonia, air, dan es. 01). Rightward shift of the QRS axis towards +90 degrees (vertical axis) or beyond ( right axis deviation)Approach to a Pacemaker ECG. There is no relation between P-waves and the escape rhythm's QRS complexes, and atrial rhythm is typically faster than the escape rhythm (both rhythms are typically regular). In 2011, Neptune completed its first 165-year orbit since its discovery. lead III accompanied by QS with notched nadir in V1; other QRS morphologies suggestive of more superior (R in II and III) or more inferior (rS/QS in II and III) lead position or and/or lack of notch in V1 were accepted when the optimal pace-mapped QRS was not obtained or the sites with such QRS did not offer deep septal lead deployment/LBB capture.