Advertisement

A young man with a narrow and a wide QRS tachycardia

      Figure 1 shows electrocardiograms (ECGs) of a 22-year-old man with a history of palpitations. He was known at the emergency department because of a 2-year history of occasional episodes of a rapid heart rhythm. The ECGs recorded at those times, one shown in Figure 1B, always revealed a narrow QRS tachycardia with alternating R-R intervals of 280 and 320 ms. Each QRS complex is followed by a P wave. Those tachycardias were terminated by intravenous adenosine. The sinus rhythm ECG outside tachycardia is shown in Figure 1A. He refused an electrophysiology study. However, one evening friends brought him to the hospital with the tachycardia shown in Figure 1C. That episode occurred during a tennis match on a very hot summer day.
      Figure thumbnail gr1
      Figure 1Twelve-lead electrocardiograms during (A)sinus rhythm, (B) a narrow QRS tachycardia, and (C) a wide QRS tachycardia.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect