This ECG could be said to have a “RBBB” type pattern in V1, rSR’ and in Lead I and V6 with a wide S wave. If the patient is an older adult with structural heart disease, WCT almost always proves to be VT.ĪBERRANT SVT? In the setting of SVT with wide QRS, the most common aberrancy is right or left bundle branch block. We should ALWAYS consider VENTRICULAR TACHYCARDIA first. The differential diagnosis of WCT includes ventricular tachycardia and supraventricular tachycardia with aberrant conduction, or interventricular conduction delay (IVCD). It is difficult to assess for the presence of P waves because of the rate and the baseline artifact. On first look, you will see a wide-complex tachycardia (WTC) with a rate around 240 per minute. This ECG is from a man who was experiencing palpitations and light-headedness with near-syncope. #SUPRAVENTRICULAR TACHYCARDIA WITH IVCD SERIES#
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