What appearance does aberrant ventricular conduction have on an EKG?

What appearance does aberrant ventricular conduction have on an EKG?

• A. A normalized QRS complex with no P wave
• B. A slightly widened QRS only following the premature beat and its P wave
• C. An elevated ST segment
• D. Multiple closely grouped P waves

Answer: (B)

Aberrant ventricular conduction is characterized by a scenario where a premature beat encounters a conduction pathway that has been altered, typically due to a refractory period. This results in a QRS complex that is not of normal duration, leading to a slightly widened appearance on the EKG. The key point is that the abnormal conduction only affects the QRS complex that follows a premature atrial or ventricular stimulus, hence showing a typically widened QRS that follows the P wave associated with the premature beat.

This distinctive appearance occurs because the premature beat fires while some of the conducting system is still refractory from the previous beat, resulting in unusual depolarization of the ventricles. The P wave corresponding to the premature beat is still present, allowing for proper identification of the sequence of events leading to the widened QRS complex.

The other options do not accurately describe the expected findings associated with aberrant conduction. For instance, a normalized QRS complex with no P wave would indicate a different type of arrhythmia where atrial activity is not captured. An elevated ST segment typically relates to ischemic changes or other cardiac events rather than conduction issues. Multiple closely grouped P waves suggest a different rhythm disturbance, such as atrial flutter or atrial tachycardia, which are