A 48 year old male came to JIPMER cardiology department with chief complaint of palpitation on and off since last two years, palpitation were acute in onset, associated with atypical chest pain. There is no history of giddiness, syncope, vomiting. Patient was referred to JIPMER cardiology department for electrophysiological study and further management. Patient ECHO study was normal.
ECG during tachycardia
Tachycardia ECG with marking
Description of the ECG- Do not jump to the diagnosis, first describe the ECG and you will reach to the diagnosis
Narrow complex regular tachycardia with heart rate of 180 per minute, negative P wave are visible in lead II,III,avF, V4,V5,V6,RP interval 160 msec, PR interval 200 msec, QRS alternans present
Diagnosis- Short RP tachycardia, PSVT most likely AVRT
Sinus ECG of the patient
Description of the ECG-NSR at 70 per minute, normal axis, No evidence of pre-excitation in the ECG
Patient underwent Electrophysiological study(EPS) at department of cardiology JIPMER, Pondicherry by Dr Raja Selvaraj and his team. During EPS patient was found to have Concealed left accessory free wall pathway with orthodromic reentrant tachycardia. Patient underwent successful radiofrequency ablation.
Approach in a patient with tachycardia
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