An Uncommon Presentation of Broad Complex Tachycardia With Aberrant Conduction in Patient With Ventricular Noncompaction Cardiomyopathy

Fatima, Urooj; Khan, Muhammad Ebrahim; Choudhary, Gunjan; Kulkarni, Abhishek; Singh, Maninder; Stapleton, Dwight D.

doi:10.1378/chest.1993960

Cited by 1 publication

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“…The Purkinje network in these patients is situated deeper into the mid-myocardium [9]. No specific ECG patterns have been described in patients with LVNC, although intraventricular conduction delay and aberrant ventricular conduction have been described [10,11].…”

Section: Atrial and Ventricular Arrhythmias In Lvncmentioning

confidence: 97%

Integrating Electrocardiography and Vectorcardiography in the Differential Diagnosis of Wide Complex Tachycardia in a Patient with Left Ventricular Noncompaction: A Case Report and Brief Literature Review

et al. 2021

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A 69-year-old woman with a history of hypertension and obesity, hospitalized with atypical chest pain, was diagnosed with left ventricular noncompaction. In-hospital monitoring of the cardiac rhythm revealed multiple episodes of atrial tachycardia and one episode of wide complex tachycardia (WCT) with left bundle branch block-like morphology and a right superior QRS axis. The electrocardiographic criteria were suggestive of a supraventricular origin of the WCT. Given the importance of reaching the correct diagnosis when dealing with a WCT, we tried to further define the pattern of ventricular activation using vectorcardiography (VCG). We analyzed the QRS loops during WCT in comparison to a sinus beat, a narrow complex tachycardia beat, and a premature ventricular contraction. The fast initial activation seen in the efferent limb of the QRS loop during the WCT was thought to be reflective of the fast initial activation via the conduction system seen in SVT with aberrancy, which was our final diagnosis for the WCT episode. This case illustrates a novel use of vectorcardiography as an additional diagnostic tool in the differential diagnosis of WCT.

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Section: Atrial and Ventricular Arrhythmias In Lvncmentioning

confidence: 97%