{"id":597405,"date":"2024-05-23T03:45:27","date_gmt":"2024-05-23T07:45:27","guid":{"rendered":"https:\/\/platohealth.ai\/wide-complex-tachycardia-with-two-qrs-morphologies-what-is-the-mechanism\/"},"modified":"2024-05-24T03:02:25","modified_gmt":"2024-05-24T07:02:25","slug":"wide-complex-tachycardia-with-two-qrs-morphologies-what-is-the-mechanism","status":"publish","type":"post","link":"https:\/\/platohealth.ai\/wide-complex-tachycardia-with-two-qrs-morphologies-what-is-the-mechanism\/","title":{"rendered":"Wide Complex Tachycardia With Two QRS Morphologies: What Is The Mechanism?","gt_translate_keys":[{"key":"rendered","format":"text"}]},"content":{"rendered":"
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Clinical introduction<\/h2>\n

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.<\/p>\n

A 12-lead ECG was obtained demonstrating a ventricular rate of 133 bpm (figure 1A). Following the infusion of intravenous magnesium and amiodarone, the \u2026 <\/p>\n