A 60-year-old man, with no known relevant history, presented to the emergency room due to dizziness and profuse sweating. Given the hemodynamic impact of the broad QRS tachycardia detected (Figure A), electrical cardioversion was performed. The electrocardiogram recorded in sinus rhythm after cardioversion is shown in Figure B.
Which disorder do you think was present?
- 1.
Probably, given the axis change, QRS width, and RS interval, this is ventricular tachycardia.
- 2.
Based on the baseline intraventricular conduction disorder, the R wave peak time in lead II (< 50ms) and the presence of RS complexes in precordial leads (V5 and V6), the patient may have aberrantly conducted supraventricular tachycardia.
- 3.
Based on the presence of a Q wave in the aVR lead>40ms (Vereckei criterion) and baseline electrocardiogram, this is probably ventricular tachycardia.
- 4.
All are incorrect.
Submit your diagnosis at http://www.revespcardiol.org/en/electroreto/71/10. The answer will follow in the next issue (November 2018). #RetoECG.