Paul A, et al. - In this single centre retrospective study, researchers estimated the incidence of short term mortality and in-hospital complications in acute qRBBB [right bundle branch block with q in leads V1,V2] ST-elevation myocardial infarction [STEMI], and identified the electrocardiographic predictors of a poor outcome. From the electronic medical records, all relevant clinical and treatment data were gathered. Data reported that 64% had a TIMI risk score of ≥ 6, and 41% were in Killip class III or IV at the time of presentation among the 272 qRBBB patients involved in the study. The authors discovered that the in-hospital mortality rate was 42.6%. High incidence of ventricular tachyarrhythmias, complete heart block, heart failure, and cardiogenic shock were observed. Acute qRBBB myocardial infarction is a sinister type of acute coronary syndrome that includes high in-hospital mortality and morbidity, requiring early detection and prompt reperfusion therapy institution. An important electrocardiographic indicator of in-hospital mortality is the extreme deviation of the QRS axis to the right [180-269 degrees].