Value of preexisting bundle branch block in the electrocardiographic differentiation of supraventricular from ventricular origin of wide QRS tachycardia
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The differentiation between ventricular tachycardia and supraventricular tachycardia with aberrant conduction: the value of the electrocardiogram
Cited by (51)
Conceptual and literature basis for wide complex tachycardia and baseline ECG comparison
2021, Journal of ElectrocardiologyCitation Excerpt :Though their seminal observations were narrowly focused on defining the origin of isolated wide complex beats with right BBB morphology, their work is recognized as delivering one of the earliest means to differentiate WCTs by way of baseline ECG comparison. Later, in 1985, Dongas and colleagues [8] examined the diagnostic value of comparing QRS morphology, QRS axis, and QRS duration between the WCT and baseline ECGs with preexisting BBB. In their report, WCTs with unchanged QRS morphologies (at leads V1, II, and III) compared to the preexisting BBB in sinus rhythm were almost invariably SWCT, while WCTs with different QRS morphologies were likely VT.
Specificity of electrocardiographic criteria for the differential diagnosis of wide QRS complex tachycardia in patients with intraventricular conduction defect
2013, Heart RhythmCitation Excerpt :Possible electrophysiological explanations for the appearance of changes in QRS morphology were discussed in more detail elsewhere.4 In summary, it is worth mentioning that the criterion established by Dongas et al10 suggesting the absence of changes in QRS morphology was based on the concept that in the presence of the complete BBB ECG pattern, conduction through the affected bundle branch is prevented and so all supraventricular beats (including sinus) would conduct exclusively through the contralateral bundle. Nevertheless, the “complete” BBB pattern may appear with a mere slowing in conduction in a bundle branch and classical studies using an atrial extrastimulus technique confirmed this finding.11,12
Value of the 12-Lead ECG in Wide QRS Tachycardia
2006, Cardiology ClinicsCitation Excerpt :The preceding criteria can be applied when only the WQRST ECG is available; as health information systems become more integrated, it should be possible to readily access a WQRST patient's prior ECGs for comparison. In such cases, the following additional criteria can be applied [2,5]: Identical QRS configuration between baseline and WQRST [2,12,13].
Tachydysrhythmias
2006, Emergency Medicine Clinics of North AmericaCitation Excerpt :In patients who have a positive QRS complex in V1, an RSR′ morphology and an Rs wave in V6 with R wave height greater than S wave depth are highly supportive of a pre-existing RBBB. In patients who have suspected SVT with LBBB morphology, the presence of an rS or QS wave in leads V1 and V2, delay to S wave nadir of <0.07 seconds, and R wave without preceding Q wave in lead V6 is diagnostic of LBBB (Fig. 12) [11–15]. There is a rate-related bundle branch delay or block.
Differential Diagnosis of Wide QRS Complex Tachycardia
2004, Cardiac Electrophysiology: Fourth EditionDifferential diagnosis of wide QRS complex tachycardia
2004, Cardiac Electrophysiology: From Cell to Bedside