Wide QRS complex tachycardia. Rapid method of prognostic evaluation

International Journal of Cardiology
Béatrice Brembilla-PerrotE Khaldi

Abstract

A wide QRS complex tachycardia suggests a ventricular tachycardia (VT); but supraventricular tachycardia (SVT) is also possible. Some authors reported on the electrocardiographic signs for the differential diagnosis of VT and SVT with aberrancy. Frequently these signs are debatable and the diagnosis is uncertain. The purpose of the study was to evaluate the interest of a non-invasive study by transesophageal route for the evaluation of the nature of a wide QRS complex tachycardia in which a reliable ECG algorithm does not permit to distinguish VT from SVT with aberrancy. Esophageal electrophysiologic study (EPS) was performed in 53 patients, aged from 16 to 85 years without bundle branch block (BBB) in sinus rhythm, but with wide-QRS tachycardia. The protocol consisted of atrial pacing at progressively higher rates and then programmed stimulation with one and two extrastimuli in control state and after isoproterenol infusion. Intracardiac EPS was performed in 49 of them. (1) Study was negative in nine patients; intracardiac EPS remained negative in four of them, induced a VT in five; (2) clinical tachycardia was induced in 44 patients: (a) in 29 of them, atrial pacing induced a BBB similar to aberrancy noted in tachycardia and ...Continue Reading

References

Nov 1, 1978·The American Journal of Cardiology·D G BendittJ J Gallagher
Feb 1, 1990·The American Journal of Cardiology·B Brembilla-PerrotC Pernot
Feb 17, 1989·JAMA : the Journal of the American Medical Association·R T SteinmanM H Lehmann
Apr 1, 1980·The American Journal of Cardiology·C J VandepolM E Josephson
Jun 1, 1993·Journal of Cardiovascular Electrophysiology·Z BlanckM Akhtar

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Citations

May 25, 2011·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·C Liesting, M J M Kofflard
Sep 10, 2015·Herzschrittmachertherapie & Elektrophysiologie·Bogdan G MunteanBarbara Bellmann
Jun 26, 2010·Congenital Heart Disease·Conrad S P WilliamsChristopher S Snyder

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