A wide QRS with a deep S wave and a characteristic P wave for each QRS indicates what condition?

The presence of a wide QRS complex combined with a deep S wave and a characteristic P wave for each QRS complex is indicative of a right bundle branch block (RBBB). In this condition, the electrical conduction through the right bundle branch of the heart is delayed, leading to the observed widening of the QRS complex.

A characteristic feature of RBBB is the presence of an "M" shape in the QRS complex in the rhythm strip, particularly in the leads V1 and V2, with deep S waves evident in the lateral leads such as V5 and V6. The P wave preceding each QRS indicates that the atrial depolarization is normal and occurring effectively, showing that the heart is maintaining sinus rhythm, despite the conduction delay in the right bundle branch.

This combination of clues is key to accurately diagnosing right bundle branch block, distinguishing it from other entities, such as ventricular tachycardia, which typically presents with significantly aberrant and rapid QRS complexes without consistent P waves. Similarly, atrial fibrillation lacks a regular P wave structure, and left ventricular hypertrophy might show changes in the T wave or other characteristics without the specific wide QRS and deep S wave pattern. Thus, RBBB emerges as the