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ECG OF THE WEEKECG OF THE WEEK
PROF .Dr .G.ELANGOVAN’S UNITPROF .Dr .G.ELANGOVAN’S UNIT
D.SUBBURAJD.SUBBURAJ
• 54/M known WPW on
T . Verapamil,
discontinued for 2 days,
developed palpitations, ECG
taken
FINDINGS IN THIS ECG
Rate -200/min
Regular rhythm
Inverted P waves –II,III,Avf
QRSD-126 ms
Left axis deviation
LBBB patter...
INVERTED P WAVES
DD FOR WCT
• Ventricular tachycardia
• SVT with
–Aberrant interventricular conduction
–Pre excitation
–Abnormal base line ...
RS INTERVAL
VT / SVT WITH ABERRANCY
• QRSD>160ms
• AV dissociation
• Regular R-R
• Extreme axis
• R on T phenomenon
• Fusion, capture ...
BRUGADA’S
CRITERIA
Arrythmias in pre excitation
• Regular – mostly AVRT
• Wide complex tachycardia
-orthodromic AVRT with aberrancy
-antidrom...
AVRT
• MC- orthodromic (90%)
• Antidromic (5%)
• Due to anomalous pathway
• PAC -blocked in aberrant pathway-conducted
in ...
• Asssociated with BBB ( MC-LBBB)
• RP>100ms
• No pseudo R ,pseudo S .
THANK U
ECG: Wide Complex Tachycardia
ECG: Wide Complex Tachycardia
ECG: Wide Complex Tachycardia
ECG: Wide Complex Tachycardia
ECG: Wide Complex Tachycardia
ECG: Wide Complex Tachycardia
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ECG: Wide Complex Tachycardia

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ECG: Wide Complex Tachycardia

  1. 1. ECG OF THE WEEKECG OF THE WEEK PROF .Dr .G.ELANGOVAN’S UNITPROF .Dr .G.ELANGOVAN’S UNIT D.SUBBURAJD.SUBBURAJ
  2. 2. • 54/M known WPW on T . Verapamil, discontinued for 2 days, developed palpitations, ECG taken
  3. 3. FINDINGS IN THIS ECG Rate -200/min Regular rhythm Inverted P waves –II,III,Avf QRSD-126 ms Left axis deviation LBBB pattern Wide complex tachycardia ST, T depression I, aVL
  4. 4. INVERTED P WAVES
  5. 5. DD FOR WCT • Ventricular tachycardia • SVT with –Aberrant interventricular conduction –Pre excitation –Abnormal base line QRS –Ventricular pacing
  6. 6. RS INTERVAL
  7. 7. VT / SVT WITH ABERRANCY • QRSD>160ms • AV dissociation • Regular R-R • Extreme axis • R on T phenomenon • Fusion, capture beats • Concordance in precordial leads • 120-160ms • Conducted P waves • Regular /irregular • Normal except in WPW • Absent • Absent • Abent
  8. 8. BRUGADA’S CRITERIA
  9. 9. Arrythmias in pre excitation • Regular – mostly AVRT • Wide complex tachycardia -orthodromic AVRT with aberrancy -antidromic AVRT -atrial arrythmia with antegrade conduction • Irregular –atrial arrythmias
  10. 10. AVRT • MC- orthodromic (90%) • Antidromic (5%) • Due to anomalous pathway • PAC -blocked in aberrant pathway-conducted in AV node-activates ventricle-reenter in to atria through aberrant pathway –retrograde P waves
  11. 11. • Asssociated with BBB ( MC-LBBB) • RP>100ms • No pseudo R ,pseudo S .
  12. 12. THANK U

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