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Rate-dependent LBBB

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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