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  • Observations
    • Absent P waves
    • QRS complexes at irregular intervals
    • Some QRS complexes are RBBB while others are LBBB (note that the lead is v1)
  • Diagnosis-
    • Best diagnosis- Atrial fibrillation with alternating bundle branch blocks
    • Second best diagnosis- Atrial fibrillation with baseline wide QRS due to non-specific conduction defect and occasional tachycardia induced RBBB aberrancy.
  • Comments are welcome!