Wide-complex tachycardia in a patient with old myocardial infarction

Area of Science:

• Cardiology
• Electrophysiology
• Internal Medicine

Background:

• Elderly patients with coronary artery disease (CAD) are susceptible to cardiac arrhythmias.
• Wide complex tachycardia (WCT) can be challenging to differentiate from ventricular tachycardia.
• Atrial fibrillation (AF) with aberrant conduction can present as WCT.

Purpose of the Study:

• To describe a case of atrial fibrillation with aberrant conduction mimicking ventricular tachycardia in an elderly patient with CAD.
• To highlight the diagnostic challenges and implications of WCT in this patient population.

Main Methods:

• Case report of an elderly male patient.
• Electrocardiogram (ECG) analysis including initial presentation and subsequent monitoring.
• Review of patient history, focusing on coronary artery disease and presenting symptoms.

Main Results:

• The patient presented with sudden palpitations and a wide complex tachycardia on ECG with left bundle branch block morphology.
• The tachycardia spontaneously terminated.
• Subsequent ECGs confirmed the diagnosis of atrial fibrillation with aberrant conduction due to a diseased left bundle branch.

Conclusions:

• Atrial fibrillation with aberrant conduction can mimic ventricular tachycardia in patients with underlying heart disease.
• Accurate diagnosis is crucial for appropriate management and to avoid unnecessary interventions.
• A thorough understanding of conduction abnormalities in the context of coronary artery disease is essential for cardiologists.