AF with aberrant conduction and concealed conduction

AF with aberrant conduction and concealed conduction. Lead V1 and lead II rhythm strips show AF with rapid ventricular response. Note that the 5^th and 6^th QRS complexes, as well as the 18^th and the 20^th to the 30^th QRS complexes, are wide with a right bundle branch pattern apparent in lead V1, while the QRS complexes for these beats in lead II are similar to native AF beats. These are all aberrantly conducted beats. While the initial or isolated aberrant beats (5^th, 18^th, and 20^th ) occur after a relative long-short interval (Ashman phenomenon), the subsequent beats (6^th and 21^st to 30^th) occur with a short-short sequence but are aberrant due to concealed conduction. For more detail, refer to UpToDate content on the electrocardiogram in atrial fibrillation.