Article Text

other Versions

PDF
Palpitations in a 46-year-old man
  1. Vineet Kumar1,
  2. Momen Eltelbany2,
  3. William Fonbah1
  1. 1Division of Cardiovascular Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA
  2. 2Faculty of Medicine, Ain Shams University, Cairo, Egypt
  1. Correspondence to Dr Vineet Kumar, Division of Cardiovascular Diseases, University of Alabama at Birmingham, FOT 930D, 1720 2nd Avenue South, Birmingham, AL 35294, USA; vkumar{at}uab.edu

Statistics from Altmetric.com

CLINICAL INTRODUCTION

A 46-year-old man with no significant medical history was seen for palpitations. A Holter monitor was placed and following recording was obtained (figure 1).

Question

What is the most likely diagnosis?

  1. Atrioventricular (AV) nodal reentrant tachycardia with aberrancy

  2. Antidromic and orthodromic tachycardia

  3. Orthodromic reentrant tachycardia with aberrancy

  4. Ventricular tachycardia

Figure 1

Holter monitor with lead I and V6 showing wide complex tachycardia at a rate of 188 beats/min (bpm; tachycardia cycle length 320 ms) which transitions to a narrower complex tachycardia at a faster rate of 222 bpm (tachycardia cycle length 270 ms).

Answer: C

Orthodromic reentrant tachycardia with aberrancy using a left side accessory pathway.

Holter monitor shows a wide complex tachycardia at a rate …

View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.