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Forty-six year old man with palpitations
  1. Vishnu Ashok1,
  2. Iain B Squire2
  1. 1 Cardiology, Glenfield Hospital, Leicester, UK
  2. 2 Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Dr Vishnu Ashok, Cardiology, Glenfield Hospital, Leicester LE3 9QP, UK; vishnuashok721{at}

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Clinical introduction

A 46-year-old man presented following an episode of palpitations after a run. Symptoms were of sudden onset with palpitations, chest tightness and light-headedness, with a recorded heart rate of 240 beats/min.

Three-lead ECG trace taken by the paramedics showed broad complex tachycardia with negative deflection in the inferior leads (see online supplementary files).

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Supplementary video


Supplementary video


Symptoms resolved spontaneously before arrival to the hospital. A strip from the 12-lead ECG on arrival is shown further.

He reported a similar episode 2 weeks prior during a cycle ride. He had no significant medical history and was physically active, with a …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.