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Left bundle branch block type wide QRS tachycardia: what is the most likely diagnosis derived from the ECG?
  1. Okan Erdogan,
  2. Alper Kepez,
  3. Halil Atas
  1. Department of Cardiology, School of Medicine, Marmara University, Istanbul, Turkey
  1. Correspondence to Alper Kepez, Marmara University Training and Research Hospital, Cardiology Clinic, Pendik, Istanbul 34890, Turkey; alperkepez{at}yahoo.com

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From the question on page 390

CLINICAL INTRODUCTION

An adult with no known cardiovascular disease presented with acute onset palpitations and near-syncope during exercise. On admission, ECG revealed wide QRS tachycardia with left bundle branch block and left superior axis morphology (Figure 1A). Because of haemodynamic instability, the patient was urgently cardioverted to sinus rhythm (Figure 1B). Serum electrolyte and cardiac troponin levels were normal. Bedside echocardiography revealed normal left ventricular size and function. Subsequent coronary angiography did not demonstrate any significant coronary artery stenosis.

Figure 1

12-Lead surface ECG during tachycardia (A) and after cardioversion (B).

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