SHM Converge Scientific Abstract ePoster Gallery-Not All Pr Intervals Are Created Equal: A Case of Unidentified Lown-Ganong-Levine Pattern

Pdf Summary

A 72-year-old man with paroxysmal atrial fibrillation presented with chest discomfort, dyspnea, dizziness, and weakness. His initial ECG was interpreted as possible wide-complex tachycardia, but telemetry and electrophysiology review later showed atypical atrial flutter with variable atrioventricular conduction.<br /><br />On closer examination of current and prior ECGs, clinicians noted a consistently short PR interval (90–138 ms) across more than 10 tracings, with a normal QRS complex and no delta waves. This pattern was consistent with an unrecognized Lown-Ganong-Levine (LGL) pattern that had been present on earlier ECGs but not reported by computer interpretation or routine overread.<br /><br />The case emphasizes that careful ECG review remains essential in patients with complex supraventricular arrhythmias. Recognizing subtle conduction patterns such as LGL can improve diagnostic accuracy, guide arrhythmia management, and support referral for electrophysiology follow-up and possible catheter ablation.<br /><br />The report also notes that many people with this pattern are asymptomatic, but LGL physiology may predispose to supraventricular arrhythmias such as atrial flutter and atrial fibrillation. Overall, the case highlights the continued importance of human interpretation alongside AI and automated ECG tools in clinical diagnostics.

Asset Subtitle

Talha Hassan

Meta Tag

Author List Shawn Chillag, Talha Hassan

Category Clinical Vignettes

Concept Short PR Interval

Concept Lown-Ganong-Levine Pattern

Concept Atrial Flutter

Concept Wide-Complex Tachycardia

Concept Normal QRS Complex

Distinguished Non-Finalist

Presenter Organization Charleston Area Medical Center

Presenting Author Talha Hassan

Track Adult

Keywords

atrial flutter

atrial fibrillation

Lown-Ganong-Levine pattern

short PR interval

electrocardiogram

wide-complex tachycardia

supraventricular arrhythmia

electrophysiology

catheter ablation

ECG interpretation

Short PR Interval

Lown-Ganong-Levine Pattern

Atrial Flutter

Wide-Complex Tachycardia

Normal QRS Complex