Clinical introduction
A man in his 50s presented to the emergency department with palpitations. He had a background of arrhythmic right ventricular cardiomyopathy. He had previously undergone the placement of a dual-chamber implantable cardioverter-defibrillator for atrioventricular block and ventricular tachycardia (VT). The device was programmed in a dual-chamber rate-modulated pacing mode with a lower rate of 80 beats per minute (bpm), an upper track/sensor rate of 120 bpm, paced atrioventricular delay (P-AVD) and sensed atrioventricular delay of 190 and 150 ms, respectively, ventricular safety pacing on and mode switch on. His regular medications included flecainide and bisoprolol.
A 12-lead ECG was obtained demonstrating a ventricular rate of 133 bpm (figure 1A). Following the infusion of intravenous magnesium and amiodarone, the …
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- Source: https://renal.platohealth.ai/wide-complex-tachycardia-with-two-qrs-morphologies-what-is-the-mechanism/