2015•HeartRequires access
Palpitations in a 46-year-old man
Vineet Kumar, Momen Eltelbany, William S. Fonbah
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Abstract
A 46-year-old man with no significant medical history was seen for palpitations. A Holter monitor was placed and following recording was obtained (figure 1).
What is the most likely diagnosis?
1. Atrioventricular (AV) nodal reentrant tachycardia with aberrancy
2. Antidromic and orthodromic tachycardia
3. Orthodromic reentrant tachycardia with aberrancy
4. Ventricular tachycardia
Figure 1
Holter monitor with lead I and V6 showing wide complex tachycardia at a rate of 188 beats/min (bpm; tachycardia cycle length 320 ms) which transitions to a narrower complex tachycardia at a faster rate of 222 bpm (tachycardia cycle length 270 ms).
Orthodromic reentrant tachycardia with aberrancy using a left side accessory pathway.
Holter monitor shows a wide complex tachycardia at a rate …