The following ECG is from a 72 yr old male who presented with chest pain and palpitations. He has a history of hypertension and hypercholesterolaemia.
|Click to enlarge
- Typical LBBB Morphology
- Apparent atrial activity within QRS in leads V5-6
- Absent fusion or capture beats
- Wide Complex Tachycardia
- SVT with aberrancy
- SVT with pre-existing BBB
- SVT with pre-excitation
Differentiating SVT from VT can be difficult and not always possible, also it may not be clinically necessary.
VT would be favoured given the patients age and co-morbidites whereas the the typical LBBB morphology and visible regular atrial activity favors SVT.
You can check out more on differentiating VT from SVT in a number of other blogs and posts, selection below:
What happened ?
The patient underwent urgent DC cardioversion and was taken for angiogram which showed a mid LAD stenosis which was stented.
References / Further Reading
Life in the Fast Lane
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.
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