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Wide QRS tachycardia
Ko Jum Suk, MD, PhD Wonkwang university school of medicine and hospital
ECG description of tachycardia
1.Regular narrow QRS tachycardia 2.Irregular narrow QRS tachycardia 3.Regular wide QRS tachycardia 4.Irregular Wide QRS tachycardia
Wonkwang university school of medicine and hospital Palpitation
Wonkwang university school of medicine and hospital Palpitation : terminated by adenosine
Adenosine
Wonkwang university school of medicine and hospital Abnormal rhythm during TMT
Wonkwang university school of medicine and hospital Palpitation with collapse
Wonkwang university school of medicine and hospital Normal conduction system
Wonkwang university school of medicine and hospital Possible mechanisms of narrow QRS tachycardia (1)
Sinus tachycardia
Atrial tachycardia
Junctional tachycardia
Atrial fibrillation
Wonkwang university school of medicine and hospital Possible mechanisms of narrow QRS tachycardia (2)
Atrial flutter
AVNRT
AVRT
ILVT
Wonkwang university school of medicine and hospital Possible mechanisms of wide QRS tachycardia
Ventricular tachycardia SVT with aberrant conduction AF with preexcitation AVRT(antidromic tachycardia)
Wonkwang university school of medicine and hospital Possible mechanisms of wide QRS tachycardia
Ventricular tachycardia SVT with aberrant conduction AF with preexcitation AVRT(antidromic tachycardia)
Wonkwang university school of medicine and hospital 28/F palpitation
Wonkwang university school of medicine and hospital AV dissociation
SAN A AVN V
Wonkwang university school of medicine and hospital RFCA
Wonkwang university school of medicine and hospital 87/M palpitation
Wonkwang university school of medicine and hospital Fusion/Capture beat
Wonkwang university school of medicine and hospital 35/F syncope
Wonkwang university school of medicine and hospital TMT
Wonkwang university school of medicine and hospital RVOT VT
Wonkwang university school of medicine and hospital RVOT VT
Wonkwang university school of medicine and hospital 43/M chest pain
Wonkwang university school of medicine and hospital PCI
Wonkwang university school of medicine and hospital Rhythm change after reperfusion
Wonkwang university school of medicine and hospital VT or SVT?
• Axis character
– Rt. Sup. Axis (northwest axis, no man’s area),
– RBBB c Lt axis deviation, LBBB c Rt. Axis deviation
– Axis shift more than 40 degree
Wonkwang university school of medicine and hospital 28/F palpitation
Wonkwang university school of medicine and hospital Concordance
Posterior Posterior
V6 V6
V1 V1 Anterior Anterior
Wonkwang university school of medicine and hospital Concordance
Wonkwang university school of medicine and hospital Morphology
Wonkwang university school of medicine and hospital 70/M palpitation
Wonkwang university school of medicine and hospital Response to adenosine
Wonkwang university school of medicine and hospital EPS : AVNRT with BBB
Wonkwang university school of medicine and hospital 50/M palpitation
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Wonkwang university school of medicine and hospital Response to adenosine
Wonkwang university school of medicine and hospital Response to adenosine
*
Wonkwang university school of medicine and hospital After CTI block
Wonkwang university school of medicine and hospital 28/F palpitation
Wonkwang university school of medicine and hospital 68/M palpitation
Wonkwang university school of medicine and hospital After cardioversion
Wonkwang university school of medicine and hospital 65/M palpitation
Wonkwang university school of medicine and hospital Adenosine
Wonkwang university school of medicine and hospital Adenosine
Wonkwang university school of medicine and hospital EPS : AVRT
Wonkwang university school of medicine and hospital 60/M dyspnea, palpitation
Wonkwang university school of medicine and hospital Telemetry
Wonkwang university school of medicine and hospital ECG after cardiooversion
Wonkwang university school of medicine and hospital PET scab
Wonkwang university school of medicine and hospital Palpitation with collapse
Wonkwang university school of medicine and hospital Electrical cardioversion
Wonkwang university school of medicine and hospital ECG after cardioversion
Wonkwang university school of medicine and hospital Confirmation and Tx of substrate
Wonkwang university school of medicine and hospital Another case of irregular wide QRS tachycardia
Wonkwang university school of medicine and hospital Palpitation
Wonkwang university school of medicine and hospital Ashman phenomenon
• Wide complex QRS complexes that follow a short R-R interval preceded by a long R-R interval • Represents an aberrantly conducted complex rat her than a complex that originates in ventricle • Refractory period of bundle branch is proportion al to the R-R interval of the preceding cycle
Wonkwang university school of medicine and hospital 67/F syncope
Wonkwang university school of medicine and hospital Telemetry
Wonkwang university school of medicine and hospital Polymorphic VT
정의 : twisting of the points 크기가 다른 QRS군이 기선을 중심으로 회전하며 바뀌는 심실빈맥 QT prolongation(>500ms) : prolonged ventricular repolarization CAVB에 의한 bradycardia에서 발생할수 있음
Long QT Polymorphic VT
Wonkwang university school of medicine and hospital 21/F SCD #01165849
Wonkwang university school of medicine and hospital Telemetry
Wonkwang university school of medicine and hospital ECG after cardioversion
Wonkwang university school of medicine and hospital ICD
Wonkwang university school of medicine and hospital ECG F/U
Wonkwang university school of medicine and hospital