| Rate-related changes in QRS morphology in patients with fixed bundle branch block: implications for differential diagnosis of wide QRS complex tachycardia. | |
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MedLine Citation:
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PMID: 18664461 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIMS: To analyse QRS morphology in response to rapid atrial pacing (RAP) and supraventricular tachycardia (SVT) in patients with pre-existing bundle branch block (BBB). METHODS AND RESULTS: We prospectively studied 59 patients in sinus rhythm (SR), with QRS > or = 120 ms, and no pre-excitation. Trains of RAP were introduced at increasing rates until atrioventricular block. QRS during SR and last QRS complex of each RAP train were compared on the 12-leads. Previously described criteria for minor and major configuration differences were used to identify QRS changes. During RAP minor QRS changes were seen in 22 (37%) and major changes in 23 (39%) subjects. One patient showed major axis shifts and no one showed a change to the contralateral BBB pattern. QRS changes were significantly and independently related to RAP rate and type of BBB (more frequent if right-BBB). Of 14 subjects (24%) with SVT, 13 displayed the same QRS changes during RAP. CONCLUSION: In patients with organic BBB, important changes in QRS morphology, except for a change in the contralateral BBB, can appear during RAP and SVT. Thus, in these patients, a change in QRS morphology during tachycardia does not necessarily imply that it is ventricular tachycardia. |
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Authors:
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Tomás Datino; Jesús Almendral; Esteban González-Torrecilla; Felipe Atienza; Francisco J García-Fernández; Angel Arenal; Leonardo Atea; Francisco Fernández-Avilés |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-07-29 |
Journal Detail:
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Title: European heart journal Volume: 29 ISSN: 1522-9645 ISO Abbreviation: Eur. Heart J. Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-02 Completed Date: 2008-11-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2351-8 Citation Subset: IM |
Affiliation:
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Cardiology Department, Hospital General Universitario, Gregorio Marañón, Doctor Esquerdo 46, Madrid 28007, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / diagnosis*, physiopathology Diagnosis, Differential Electrocardiography / methods Female Heart Function Tests Heart Rate / physiology Humans Male Middle Aged Prospective Studies Tachycardia, Supraventricular / diagnosis*, physiopathology Tachycardia, Ventricular / diagnosis*, physiopathology |
| Comments/Corrections | |
Comment In:
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Eur Heart J. 2008 Oct;29(19):2319-20
[PMID:
18757869
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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