What are the possibilities in this wide QRS tachycardia? – Discussion

Discussion Wide QRS complex tachycardia with a rate of around 225/min. Wide QRS tachycardia is to be taken as ventricular tachycardia until proved otherwise. Monophasic negative wide QRS complexes are seen from V1-V5. V6 shows positive wide QRS complex with LBBB morphology. Similar morphology is seen in leads I and aVL as well. The QRS voltages are low in limb leads. Lead II shows multiple irregularities in P waves which could be dissociated P waves. The atrial rate calculated from the dissociated P waves seems to similar to that of the tachycardia rate, though one cant be very sure as to which irregularities are P waves and which are artifacts! Atrial flutter with 1:1 conduction and aberrant ventricular conduction is another possibility to be considered with a fast rhythm. But the usual rate of atrial flutter waves is 300/min, unless the flutter has been slowed by some other mechanism. Presence of dissociated P waves is against the diagnosis of atrial flutter. Other types of supraventricular tachycardia with aberrancy of ventricular conduction are also excluded by the same feature. Back to question The post What are the possibilities in this wide QRS tachycardia? – Discussion appeared first on Cardiophile MD.
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology ECG Library Source Type: blogs