Wide QRS complex tachycardia in a patient with wide QRS complex sinus rhythm due to left bundle branch block pattern
András Vereckei1
Katalin Vadász2
András Zsáry1
1.3rd Department of Medicine, Semmelweis University, Budapest, Hungary2.2nd Department of Medicine, Semmelweis University, Budapest, Hungary
摘要：A 58-year-old man with hypertension and half a year ago documented left bundle branch block (LBBB) in his past history presented with progressive dyspnea.A pre-admission echocardiography showed severely depressed systolic left ventricular function [ejection fraction (EF) =27％], diffuse hypokinesis and dilated heart chambers consistent with dilated cardiomyopathy (DCM).On admission, he presented with dyspnea on minimal exertion, his blood pressure was 100/70 mmHg, his heart rate was 62 beats/min with occasional mild irregularities suggesting premature beats.The electrocardiogram (ECG) showed a 67 beats/min sinus rhythm with complete LBBB pattern and a QRS duration of 170 ms (Figure 1A).Telemetry first revealed a 170-175 beats/min wide QRS complex tachycardia (WCT) consisting of six beats with right bundle branch block (RBBB) pattern, which followed a 62 beats/min sinus rhythm with LBBB pattern (Figure 1B), later showed two initial sinus beats with a heart rate of 54 beats/min and LBBB pattern and a QRS duration of 170 ms followed by an irregular wide QRS complex rhythm with a 78-102 beats/min mean ventricular rate, with QRS complexes of 150 ms QRS duration and a QRS morphology resembling LBBB (Figure 1C).Apparently at first glance, AV dissociation was not present during the irregular wide QRS complex rhythm, because the number of P-waves and QRS complexes were equal.
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论文发表日期：2020-08-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：3( 530-532 )
英文信息