Open AccessWide QRS complex tachycardia responsive to both ATP and verapamil
Author(s) -
Nishizaki Mitsuhiro
Publication year - 2012
Publication title -
journal of arrhythmia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 21
eISSN - 1883-2148
pISSN - 1880-4276
DOI - 10.1016/j.joa.2012.02.012
Subject(s) - medicine , cardiology , tachycardia , qrs complex , sinus tachycardia , palpitations , electrocardiography , sinus rhythm , supraventricular tachycardia , accessory pathway , verapamil , anesthesia , ventricular tachycardia , heart rate , catheter ablation , atrial fibrillation , blood pressure , calcium
A 38-year-old female with frequ ent episodes of palpitation was referred to our hospital for the diagnosis and management of tachycardia. Her annual medical checkups did not reveal any abnormalities, and she had no history of cardiovascular diseases or medications. Her family history was negative for cardiac events and sudden death. No obvious structural heart disease was detected during physical examination, resting electrocardiography, chest radiography, or echocardiography. She generally had palpitations during exercise and when she was under emotional stress, and they terminated spontaneously within 2 h. Surface 12-lead electrocardiogram (ECG) obtained during a lasting episode of palpitation showed wide QRS complex tachycardia with a right bundlebranch block (BBB) pattern and inferior axis (Fig. 1). This tachycardia transiently developed from sinus tachycardia occurring after psychological stress and disappeared spontaneously, with the restoration of sinus rhythm (Fig. 2). A small dose of ATP temporarily suppressed the tachycardia, which was then completely eliminated after the administration of a 5.0-mg dose of verapamil (Fig. 3). What is your diagnosis of the tachycardia and its mechanism?