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Wide Complex Tachycardia in a Young Woman.

ABSTRACT: A 27-year-old woman presented with palpitations and was found to have episodes of a non-sustained wide complex tachycardia. In this report, we discuss a differential diagnosis for the patient's wide complex tachycardia and the important ECG findings which lead to her diagnosis. (Level of Difficulty: Advanced.).

SUBMITTER: Raber I

PROVIDER: S-EPMC8414418 | biostudies-literature |

REPOSITORIES: biostudies-literature

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In memory of tachycardia: A wide complex tachycardia in a young male

Project description:Abstract We present a case of a 24?year?old male with palpitations and a wide complex tachycardia. Baseline electrocardiogram (ECG) after termination of tachycardia demonstrates a normal rhythm but with inferior/anterolateral T?wave inversions (TWIs). Electrophysiologic study confirmed the diagnosis of posterior fascicular ventricular tachycardia successfully terminated by anatomic ablation of the left posterior fascicle. TWIs on the patient's baseline ECG were consistent with cardiac memory. Twenty?four?year?old male presents with palpitations and wide complex tachycardia on ECG. Baseline ECG after termination of tachycardia demonstrates a normal rhythm but with inferior/anterolateral T?wave inversions (TWIs). Electrophysiologic study confirms the diagnosis of posterior fascicular ventricular tachycardia with successful anatomic ablation of the left posterior fascicle. TWIs were consistent with cardiac memory.

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A Young Woman With Recurrent Palpitations: A Case of Ebstein Anomaly With Mahaim Fiber Tachycardia.

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Wide Complex Tachycardia and Flecainide: A Dangerous Couple.

Project description:Differential diagnosis of wide complex tachycardia in patients taking anti-arrhythmic can be challenging. Conventional ECG diagnostic criteria are poorly specific and should be applied with caution. Patients who develop life-threatening arrhythmias after flecainide infusion should be screened for Brugada Syndrome, especially if concomitant sinus node dysfunction is present. (Level of Difficulty: Intermediate.).

| S-EPMC8414423 | biostudies-literature

Wide Complex Tachycardia in Patient With Cardiac Device.

Project description:Electrocardiographic clues for a differential diagnosis of wide complex tachycardia in a patient with a pacemaker are presented. (Level of Difficulty: Intermediate.).

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Wide Complex Tachycardia and Cardiac Arrest During Endoscopy.

Project description:A 59-year-old man presented for implantable cardioverter-defibrillator placement after a wide QRS complex tachycardia cardiac arrest at an outside hospital. In this case report, we discuss the differential diagnosis of this patient's tachyarrhythmia and the electrophysiological studies that established the diagnosis and guided management. (Level of Difficulty: Intermediate.).

| S-EPMC8855126 | biostudies-literature

Wide complex tachycardia discrimination tool improves physicians' diagnostic accuracy.

Project description:BackgroundTimely and accurate discrimination of wide complex tachycardias (WCTs) into ventricular tachycardia (VT) or supraventricular WCT (SWCT) is critically important. Previously we developed and validated an automated VT Prediction Model that provides a VT probability estimate using the paired WCT and baseline 12-lead ECGs. Whether this model improves physicians' diagnostic accuracy has not been evaluated.ObjectiveWe sought to determine whether the VT Prediction Model improves physicians' WCT differentiation accuracy.MethodsOver four consecutive days, nine physicians independently interpreted fifty WCT ECGs (25 VTs and 25 SWCTs confirmed by electrophysiological study) as either VT or SWCT. Day 1 used the WCT ECG only, Day 2 used the WCT and baseline ECG, Day 3 used the WCT ECG and the VT Prediction Model's estimation of VT probability, and Day 4 used the WCT ECG, baseline ECG, and the VT Prediction Model's estimation of VT probability.ResultsInclusion of the VT Prediction Model data increased diagnostic accuracy versus the WCT ECG alone (Day 3: 84.2% vs. Day 1: 68.7%, p 0.009) and WCT and baseline ECGs together (Day 3: 84.2% vs. Day 2: 76.4%, p 0.003). There was no further improvement of accuracy with addition of the baseline ECG comparison to the VT Prediction Model (Day 3: 84.2% vs. Day 4: 84.0%, p 0.928). Overall sensitivity (Day 3: 78.2% vs. Day 1: 67.6%, p 0.005) and specificity (Day 3: 90.2% vs. Day 1: 69.8%, p 0.016) for VT were superior after the addition of the VT Prediction Model.ConclusionThe VT Prediction Model improves physician ECG diagnostic accuracy for discriminating WCTs.

| S-EPMC9799284 | biostudies-literature

The Wide Complex Tachycardia Formula: Derivation and validation data.

Project description:A recent publication (May et al., 2019) introduced a novel means (i.e. WCT Formula) to automatically distinguish ventricular tachycardia and supraventricular wide complex tachycardia using modern-day computerized electrocardiogram software measurements. In this article, a summary of data components relating to the derivation and validation of the WCT Formula is presented.

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Wide-complex tachycardia in a patient with old myocardial infarction.

Project description:An elderly man with a history of coronary artery disease presented with sudden-onset palpitations. The electrocardiogram showed wide complex tachycardia with left bundle branch morphology which terminated spontaneously. Subsequent ECGs confirmed the diagnosis as atrial fibrillation with aberrant conduction because of a diseased left bundle.

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Automatic wide complex tachycardia differentiation using mathematically synthesized vectorcardiogram signals.

Project description:BackgroundAutomated wide complex tachycardia (WCT) differentiation into ventricular tachycardia (VT) and supraventricular wide complex tachycardia (SWCT) may be accomplished using novel calculations that quantify the extent of mean electrical vector changes between the WCT and baseline electrocardiogram (ECG). At present, it is unknown whether quantifying mean electrical vector changes within three orthogonal vectorcardiogram (VCG) leads (X, Y, and Z leads) can improve automated VT and SWCT classification.MethodsA derivation cohort of paired WCT and baseline ECGs was used to derive five logistic regression models: (i) one novel WCT differentiation model (i.e., VCG Model), (ii) three previously developed WCT differentiation models (i.e., WCT Formula, VT Prediction Model, and WCT Formula II), and (iii) one "all-inclusive" model (i.e., Hybrid Model). A separate validation cohort of paired WCT and baseline ECGs was used to trial and compare each model's performance.ResultsThe VCG Model, composed of WCT QRS duration, baseline QRS duration, absolute change in QRS duration, X-lead QRS amplitude change, Y-lead QRS amplitude change, and Z-lead QRS amplitude change, demonstrated effective WCT differentiation (area under the curve [AUC] 0.94) for the derivation cohort. For the validation cohort, the diagnostic performance of the VCG Model (AUC 0.94) was similar to that achieved by the WCT Formula (AUC 0.95), VT Prediction Model (AUC 0.91), WCT Formula II (AUC 0.94), and Hybrid Model (AUC 0.95).ConclusionCustom calculations derived from mathematically synthesized VCG signals may be used to formulate an effective means to differentiate WCTs automatically.

| S-EPMC8739609 | biostudies-literature

A case report of a patient with wide complex tachycardia due to Wolff-Parkinson-White syndrome mimicking ventricular tachycardia.

Project description:BackgroundWide complex tachycardia (WCT) associated with syncope as manifestation of an underlying, life-threatening arrhythmia might potentially be the harbinger of sudden cardiac death. Identifying the aetiology of a WCT is imperative to provide appropriate treatment and prevent recurrence.Case summaryWe report the case of a 22-year-old male who had been experiencing haemodynamically significant WCT leading to syncope at the age of 13 years. As the patient and the family rejected an electrophysiological (EP) study, he had received an implantable cardioverter-defibrillator (ICD) for secondary prevention. After 7 years of experiencing multiple shocks, the patient finally gave consent to an EP study, which identified a left-sided accessory atrioventricular pathway that was successfully ablated during the same procedure.DiscussionThe differential diagnosis of WCT might be challenging and includes both ventricular and supraventricular tachycardias. In young patients without structural heart disease experiencing WCT, an EP study should be offered before ICD implantation to make a final diagnosis with the potential to provide definitive treatment.

| S-EPMC8517903 | biostudies-literature

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