Wide QRS tachycardia with right bundle branch block QRS morphology that is almost identical to that during sinus rhythm: What is the mechanism?

2018 ◽  
Vol 29 (6) ◽  
pp. 929-931
Author(s):  
Yasushi Wakabayashi ◽  
Takekuni Hayashi ◽  
Yoshitaka Sugawara ◽  
Takeshi Mitsuhashi ◽  
Hideo Fujita ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Right Bundle Branch Block ◽  
Bundle Branch Block ◽  
Qrs Morphology

Diagnosis and Ablation of Fascicular Tachycardia

2011 ◽  
Vol 3 (1) ◽  
pp. 67
Author(s):  
Akihiko Nogami ◽  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Axis Deviation ◽  
Exit Site ◽  
Rare Form ◽  
Bundle Branch Block ◽  
Diagnosis And Therapy ◽  
Narrow Qrs ◽  
Left Posterior ◽  
Qrs Morphology

Verapamil-sensitive fascicular ventricular tachycardia (VT) is the most common form of idiopathic left VT. According to the QRS morphology and the successful ablation site, left fascicular VT can be classified into three subgroups: left posterior fascicular VT, whose QRS morphology shows right bundle branch block (RBBB) configuration and superior axis (common form); left anterior fascicular VT, whose QRS morphology shows RBBB configuration and right-axis deviation (uncommon form), and upper septal fascicular VT, whose QRS morphology shows narrow QRS configuration and normal or right-axis deviation (rare form). Posterior and anterior fascicular VT can be successfully ablated at the posterior or anterior mid-septum with a diastolic Purkinje potential during VT or at the VT exit site with a fused pre-systolic Purkinje potential. Upper septal fascicular VT can also be ablated at the site with diastolic Purkinje potential at the upper septum. Recognition of the heterogeneity of this VT and its unique characteristics should facilitate appropriate diagnosis and therapy.

scholarly journals Differentiating the QRS Morphology of Posterior Fascicular Ventricular Tachycardia From Right Bundle Branch Block and Left Anterior Hemiblock Aberrancy

2017 ◽  
Vol 10 (9) ◽  
Author(s):  
Yoav Michowitz ◽  
Oholi Tovia-Brodie ◽  
Ishai Heusler ◽  
Avi Sabbag ◽  
Michael Rahkovich ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Bundle Branch Block ◽  
Qrs Morphology ◽  
Anterior Hemiblock

scholarly journals A new ECG sign of an accessory pathway in sinus rhythm: pseudo partial right bundle branch block

Heart ◽  
1999 ◽  
Vol 82 (2) ◽  
pp. 244-245 ◽  
Author(s):  
E W Lau ◽  
G A Ng ◽  
M J Griffith
Keyword(s):  
Sinus Rhythm ◽  
Right Bundle Branch Block ◽  
Accessory Pathway ◽  
Bundle Branch Block

A wide complex tachycardia with atypical right bundle branch block QRS morphology: What is the mechanism?

2018 ◽  
Vol 29 (9) ◽  
pp. 1325-1326
Author(s):  
Mark T. K. Tam ◽  
Joseph Y. S. Chan ◽  
George J. Klein
Keyword(s):  
Right Bundle Branch Block ◽  
Bundle Branch Block ◽  
Wide Complex Tachycardia ◽  
Qrs Morphology

Diagnosis and Ablation of Fascicular Tachycardia

2010 ◽  
Vol 6 (4) ◽  
pp. 79 ◽  
Author(s):  
Akihiko Nogami ◽  
Keyword(s):  
Ventricular Tachycardia ◽  
Right Bundle Branch Block ◽  
Axis Deviation ◽  
Exit Site ◽  
Rare Form ◽  
Bundle Branch Block ◽  
Diagnosis And Therapy ◽  
Narrow Qrs ◽  
Left Posterior ◽  
Qrs Morphology

Verapamil-sensitive fascicular ventricular tachycardia (VT) is the most common form of idiopathic left VT. According to the QRS morphology and the successful ablation site, left fascicular VT can be classified into three subgroups: left posterior fascicular VT, whose QRS morphology shows right bundle branch block (RBBB) configuration and superior axis (common form); left anterior fascicular VT, whose QRS morphology shows RBBB configuration and right-axis deviation (uncommon form), and upper septal fascicular VT, whose QRS morphology shows narrow QRS configuration and normal or right-axis deviation (rare form). Posterior and anterior fascicular VT can be successfully ablated at the posterior or anterior mid-septum with a diastolic Purkinje potential during VT or at the VT exit site with a fused pre-systolic Purkinje potential. Upper septal fascicular VT can also be ablated at the site with diastolic Purkinje potential at the upper septum. Recognition of the heterogeneity of this VT and its unique characteristics should facilitate appropriate diagnosis and therapy.

Abstract 20130: Permanent Pacemaker Implantation Following Heart Surgery: In-Hospital and Postoperative Retrospective Multicentre Evaluation in 1,156 Implants

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Roberto Lorusso ◽  
Fabio Barili ◽  
Antonio Miceli ◽  
Alessandro Parolari ◽  
Francesco Alamanni ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cardiac Surgery ◽  
Sinus Rhythm ◽  
Right Bundle Branch Block ◽  
Permanent Pacemaker ◽  
P Value ◽  
Routine Practice ◽  
Multivariate Logistic Regression ◽  
Bundle Branch Block

Introduction: Permanent pacemaker (PPM) implantation represents a potential event after cardiac surgery. However, comprehensive investigation of robust patient cohorts in this respect is unavailable. Hypothesis: A multicenter retrospective study was undertaken to assess in-hospital and long-term postoperative outcome of a large patient population undergoing PPM soon after cardiac surgery procedures. Methods: Among 94.693 patients submitted to cardiac surgery procedures in 16 centers from 2000 to 2013, there were 1.156 patients (1.2 %) with PPM implantation during hospitalization postoperatively. Preoperative, in-hospital, and follow-up data were collected with a common dataset and analyzed. Follow-up was performed by direct visit, and PPM dependency was assessed by electrocardiogram and pacemaker check during periodic examinations. The identification of potential predictors of PPM dependency at follow-up was evaluated with a multivariate logistic regression. Results: Patient mean age was 69 years (range 17-92 years) and 53.4% were male. Preoperative electrocardiogram showed first degree atrio/ventricular block in 11.0% of patients, left bundle branch block in 11.1%, right bundle branch block in 11.0%, and atrial fibrillation in 22.8%, respectively. Most of the patients had had isolated aortic valve replacement (25.8%). Pacemakers were implanted after a median of 11 days after surgery. At follow-up, 43.6% of the patients did not show a PPM dependency with restoration of sinus rhythm. The multivariate logistic regression demonstrated that only preoperative right bundle branch block (p-value 0.031) and mitral valve repair (p-value 0.032) were independent risk factor for PPM dependency at follow-up. Conclusions: More than 40% of patients with PPM implantation shortly after cardiac surgery show recovery of sinus rhythm at follow-up. Wide variability of strategies and PM implant timing are currently applied in routine practice. Refinement of current guidelines in this setting based also on predictors of permanent conduction defects postoperatively are warranted.

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