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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
06:57

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Published on: January 31, 2019

What is this? VT versus SVT.

Prabha Nini Gupta1, Anup Kumar, Narayanan Namboodiri

  • 1Department of Cardiology, Medical College Hospital, Trivandrum, Kerala, India.

BMJ Case Reports
|September 26, 2013
PubMed
Summary
This summary is machine-generated.

Diagnosing wide QRS tachycardia can be challenging. This case highlights electrocardiogram (ECG) features suggestive of epicardial ventricular tachycardia (VT) in a patient with coronary artery disease.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Wide QRS tachycardia presents a diagnostic challenge, often requiring differentiation between supraventricular tachycardia (SVT) and ventricular tachycardia (VT).
  • Epicardial VT, originating from the outer surface of the heart, has specific electrocardiogram (ECG) characteristics that aid in its diagnosis.

Observation:

  • The patient presented with wide QRS tachycardia, initially posing difficulty in distinguishing between SVT and VT.
  • Specific ECG criteria, including sinus capture beats, pseudo-delta waves, and wide QRS complexes, suggested VT of epicardial origin.
  • Coronary angiography revealed significant coronary artery disease in the patient.

Findings:

  • The ECG findings were strongly indicative of epicardial ventricular tachycardia.
  • The patient underwent successful stenting for significant coronary artery disease.
  • A subsequent electrophysiological study was performed for further evaluation.

Implications:

  • Recognizing specific ECG patterns is crucial for differentiating epicardial VT from other wide QRS tachycardias.
  • Coronary artery disease can be associated with epicardial VT, necessitating comprehensive cardiac evaluation.
  • This case underscores the importance of integrating ECG analysis, coronary angiography, and electrophysiological studies for optimal patient management.