Wide QRS tachycardia with alternating QRS morphologies: What is the mechanism?

Widening of the QRS complex during the wide complex tachycardia: What is the mechanism?

Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. This article is protected by copyright. All rights reserved.

Simultaneous narrow and wide QRS complex tachycardia: Misdiagnosis or Missed diagnosis?

Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. Regardless of the mechanism, this case illustrates the importance of assessing the response to multiple different pacing maneuvers in determining the mechanism of narrow and wide QRS complex tachycardias, rather than relying upon a single maneuver, even one that is believed to be diagnostic. This article is protected by copyright. All rights reserved.

Transient changes in QRS morphology during a narrow complex tachycardia: What is the mechanism?

The observation of electrograms and electrocardiograms recorded in sinus rhythm can offer important initial information about the mechanism of arrhythmia. Some patients may have both bundle branch aberrancy or a bystander pathway or multiple pathways, giving rise to varying degrees of QRS fusion. There is need to focus on any change in cycle length of the tachycardia and morphology of QRS during tachycardia. This article is protected by copyright. All rights reserved.

Transition from Two Wide to A Narrow QRS Complex Tachycardia: What is the mechanism of tachycardia and transition?

Spontaneous transition from one tachycardia to another tachycardia poses a challenge to the electrophysiologists and most likely occurs by multiple mechanisms. This article is protected by copyright. All rights reserved.

An Incessant Tachycardia with Alternating QRS Complexes: What Is the Mechanism?

We present a patient with ischemic cardiomyopathy who had ventricular tachycardia (VT) with QRS morphology alternans. The electrophysiological findings, in this case, supported the occurrence of antegrade activation of the proximal His–Purkinje system during VT, with the ultimate electrocardiogram morphology dependent on fusion from intramyocardial and His–Purkinje activations.

A Wide QRS Tachycardia with Three Distinct Left Bundle Branch Block Morphologies in a Patient with Sinus Rhythm with Left Bundle Branch Block: What Is the Mechanism?

The differential diagnosis for a wide complex tachycardia includes all causes of supraventricular tachycardia (SVT) with bundle branch block or all causes of SVT with antegrade pre-excitation by bystander involvement of any accessory pathways, myocardial or bundle brunch ventricular tachycardia, and antidromic (atriofascicular or nodofascicular/nodoventricular) and other pre-excited reciprocating tachycardias. We present a case of wide complex QRS tachycardia with a left bundle branch block QRS morphology.