###Human: Had ECG for palpitations. Please have a look and assess further steps. ###Assistant: Hello. I reviewed carefully your ECG images (attachment removed to protect patient identity) and would explain that besides right axis deviation, I also noticed the presence of prominent P waves in DII lead, which indicates a pattern or left the posterior fascicular block. For this reason, I would recommend performing a cardiac ultrasound to examine the heart and exclude possible structural abnormality. Regarding the tingling, I would also recommend checking the thyroid hormone levels and blood electrolytes for possible imbalance. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need. cardiac structural abnormality. Cardiac ultrasound.