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Aberrant conduction

Wide-complex Tachycardia: Ventricular Tachycardia

Tue, 06/14/2016 - 14:23 -- Dawn

This ECG is from a man who was experiencing palpitations and light-headedness with near-syncope. On first look, you will see a wide-complex tachycardia (WTC) with a rate around 240 per minute.  It is difficult to assess for the presence of P waves because of the rate and the baseline artifact. 

ECG Basics: Atrial Flutter With 2:1 Conduction And An Aberrantly-conducted Beat

Sun, 08/23/2015 - 12:20 -- Dawn

This strip was taken from a patient at rest.  It shows a regular tachycardia with a slightly-widened QRS complex at about .10 seconds duration.  It is somewhat difficult to evaluate the baseline for P waves or flutter waves.  We ALWAYS recommend multi-lead assessment for such evaluation.  The P waves (or flutter waves) here have a sharp point, and can be easily "marched out", with a rate of about 300 per minute.

Spontaneously Changing Conduction In Wide Complex Tachycardia

Wed, 04/10/2013 - 22:23 -- Dawn

This ECG was donated to the ECG Guru by Dr. Arnel Carmona, one of our favorite Gurus.  You will not often see such a great example of this.  We are very grateful to Dr. Carmona for his contribution to learning. Dr. Carmona's new blog is EZG - ECG for beginners and enthusiasts.    

PACs With Left Anterior Fascicular Block Aberrancy

Mon, 10/08/2012 - 19:08 -- Dawn

A good example of aberrantly conducted premature beats (PACs or possibly PJCs) that are conducted with a left anterior fascicular block.  The underlying rhythm is sinus at about 80/min.  The timing of the premature beats is best seen in the Lead II rhythm strip at the bottom, as this ECG machine does not print the 12 leads in an uninterrupted manner.  You will see interruptions each time the leads change.

SVT with Rate-dependent LBBB; Rhythm Strip

Wed, 11/30/2011 - 14:00 -- Dawn

This series of rhythm strips demonstrates a supraventricular tachycardia with a wide QRS. The SVT stops abruptly after a 6 mg dose of adenosine is given IVP. This confirms the diagnosis of SVT vs sinus tachycardia. When the tachycardia stops, a sinus rhythm resumes, and the QRS is now narrow. This confirms that the bundle branch block was rate-dependent. This is caused by differing refractory periods in the fasicles - the right bundle branch was able to recover its function quickly during the tachycardia, but the left bundle was not able to keep up at that rate.

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