Gepubliceerd in:
01-05-2012 | Rhythm puzzle - Question
Alternating bizarrely shaped broad QRS complex tachycardia: What is the mechanism?
Gepubliceerd in: Netherlands Heart Journal | Uitgave 5/2012
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A 78-year-old man known with paroxysmal atrial fibrillation was seen in the emergency department because of palpitations and dyspnoea complaints. He was on beta-blockers, aspirin and flecainide. His electrocardiogram showed a broad QRS-complex tachycardia with a left bundle branch block ‘like’ morphology and QRS alternans (Fig. 1). Two minutes later his rhythm stabilised spontaneously (Fig. 2). What is your diagnosis?
Fig. 1
Broad QRS complex tachycardia with obvious QRS alternans
Fig. 2
ECG after spontaneous stabilisation of the tachycardia
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