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ECG library

Long QT

core

A 44-year-old on methadone, ondansetron, and now ciprofloxacin. Routine ECG before discharge.

25 mm/s · 10 mm/mV · synthetic tracing
100%
IIIIIIaVRaVLaVFV1V2V3V4V5V6
II (rhythm)
Calipers:2000 ms50.0 small boxes30 bpm if R-RDrag the orange markers. One small box = 40 ms.

Key findings

  • QTc above 500 ms
  • An additive medication list
  • Check potassium and magnesium

Learning points

  • Eyeball rule: a QT beyond half the RR interval deserves a formal measurement.
  • The fix is subtraction: stop the QT-prolonging drugs, replace K and Mg, and repeat the tracing.

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