Ventricular tachycardia with QRS configuration similar to that in sinus rhythm and a myocardial origin: differential diagnosis with bundle branch reentry

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
H GuoB Olshansky

Abstract

Tachycardia with a QRS configuration which resembles that in sinus rhythm is usually thought to be supraventricular. Ventricular tachycardia, with a similar QRS configuration to that in sinus rhythm on the 12-lead ECG, can occur. The mechanisms of this form of ventricular tachycardia have not been previously reported. The mechanism of ventricular tachycardia was defined during electrophysiological study in five patients. During sinus rhythm, all patients had a wide QRS complex (>0.12 s) on the 12-lead ECG. The morphology remained grossly unchanged during spontaneous, symptomatic tachycardia. Four of the five patients had coronary artery disease and left ventricular dysfunction. The remaining patient had idiopathic dilated cardiomyopathy. The relationship between the His bundle, deflection, the right bundle branch and the QRS complex was evaluated during tachycardia. Atrial and ventricular pacing, and ventricular activation mapping were performed during tachycardia to define the tachycardia mechanism. The tachycardia induced at electrophysiological testing, which was similar to the clinical tachycardia, was proven to be ventricular tachycardia in each patient. The morphology of ventricular tachycardia was right bundle branch blo...Continue Reading

Citations

Dec 15, 2004·Current Opinion in Cardiology·William G Stevenson
Mar 1, 2008·Pacing and Clinical Electrophysiology : PACE·Katja Zeppenfeld, William G Stevenson
Apr 2, 2009·Pacing and Clinical Electrophysiology : PACE·Amir AbdelwahabJohn L Sapp
Apr 29, 2008·Pacing and Clinical Electrophysiology : PACE·Bipinpreet NagraSteven Kalbfleisch
Feb 10, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Ramprakash BalasundaramCalambur Narasimhan
Jun 7, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Andrew LiuJohn L Sapp
Aug 30, 2018·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Jorge RomeroLuigi Di Biase

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