Right-sided ECG chest leads and native heart ventricular fibrillation evaluation in a heterotopic cardiac transplant recipient

Introduction and description of ECG findings ECG diagnosis of Ventricular Fibrillation (VF) in Heterotopic Cardiac transplant recipients is complemented by using right-sided precordial chest leads placed in the right-sided mirror image positions of the standard left-sided precordial leads position. In this particular patient with terminal native heart cardiac failure and VF based on a standard twelve lead ECG (Fig. 1) as evidenced 3 with regular donor heart QRS complexes interspersed in between, almost akinetic native heart ventricles with hardly any excursions of the mitral valve or the aortic valve leaflets on echocardiography was demonstrable, and progressively worsening hemodynamic status resulting from increasing dependence on the smaller donor heart was seen (a heterotopic cardiac transplant was performed in the first place for the same reason – a small donor heart).by the irregular rapid VF waves seen inthe background in the left-sided chest leads V2