This is a 42 year old male patient he had previous svt 5 years ago presented to me with palpitations and giddiness. What does ecg show? echo showed lvh otherwise normal. investigation and treatment options.

1 Like


Very interesting ECG 's. 1. From the last one ,sinus rhythm with lt axis deviation and Rt ventricular preponderance. 2.All rest ecgs are SVT rhythm with different rate with protian types of abberant conduction. 3.1st ecg may be confused with vt but seeing other it is SVT with fast rate and aberant conduction. 4.Electolytes, EP study to be required. If pt is hypertensive beta blocker /verapamil /isoptin may be started along with ace/arb.As it does not appear to be sustained acute treatment may not be required or unnecessary. 5.Finally pt to be evaluated for CAD.

yes last ecg when sinus rhythm is their shows short pr interval (WPW syndrome )

Looks like preexitation Afib grossly irregular rhythm wide qrs positive concordance initial qrs slurring seen in anterior chest leads called delta wave equivalent after cardioversion should undergo RFA in index hospitalization I think patient could have more than one pathway, one of them definitely is posterioseptal NSR ECG also shows preexitation with posterioseptal pathway

The ECG shows narrow complex tachycardia and at other place broad complex (ventricular) tachycardia with atrial fibrillation. If the heart is compensated , use cordarone iv as per shedule. If decompressed cadioversion according to protocol . Follow up cordarone, warf , Atorvastatin, ARB Angiography, and ABG should be done

It's a k/c/on on case of AF so administer him inj adenosine slow iv, inj digitized 4cc iv then follow up with table Amidon 200mg 2tds for 1week plus a sitcom 2mg bed time with steins and monitor pti /inr, with Holter

all should remember that in wpw with AF avoid AV nodal blocking drugs like beta blocker,ccbs,digoxin and to avoid adenosine as it does not work on accessory pathway and can trigger CHB or VF in these subsets

sir may i know how patient was managed on presentation

already ablation done refer to my old post adenosine should not be given its af with fvr with wpw syndrome cardarone was given initially pt developed cardarone associated hyperthyroidism

Ok. Got it.

yday evening cag done it showed only ectatic coronary following did ep study and rfa two pathways left posterior and left posterio lateral accessory successful ablation completion i'l post pictures soon

It is has narrow complex tachycardia..electrolytes need to be investigated .n options are dilatezam metprolol.n monitoring of ecg n bp is needee.if pt hd unstable even cardio version is needed

VT with abberancy


Load more answers

Diseases Related to Discussion