Figure 1
Ecg12
Cardiology
A 72 y/o woman presented to ED with palpitation. She had a history of left ventricular systolic dysfunction for the last 3 years.
This is a wide complex tachycardia (WCT). In case of WCT, differential diagnosis should be made between ventricular tachycardia (VT), supraventricular tachycardia with aberrancy and Pre-excited tachycardia.
The followings enabled us to diagnose VT.
- Initial q wave >40 msec in aVR ( Vereckei aVR criteria for VT).
- Right bundle branch block morphology in V1 and rS in V6 ( Brugada morphology criteria for VT). If this were a supraventricular tachycardia with a right bundle branch block aberrancy, then we would see "qRs" in V6, not rS!
So this is VT in RBBB morphology! #cardiopaedia