Differential diagnosis of tachycardia with a typical left bundle branch block morphology.

World J Cardiol

Jeffrey S Neiger, Richard G Trohman, Department of Medicine, Section of Cardiology, Clinical Cardiac Electrophysiology Service, Rush University Medical Center, Chicago, IL 60612, United States.

Published: May 2011

The evaluation of wide QRS complex tachycardias (WCT) remains a common dilemma for clinicians. Numerous algorithms exist to aid in arriving at the correct diagnosis. Unfortunately, these algorithms are difficult to remember, and overreliance on them may prevent cardiologists from understanding the mechanisms underlying these arrhythmias. One distinct subcategory of WCTs are those that present with a "typical" or "classic" left bundle branch block pattern. These tachycardias may be supraventricular or ventricular in origin and arise from functional or fixed aberrancy, bystander or participating atriofascicular pre-excitation, and bundle branch reentry. This review will describe these arrhythmias, illustrate their mechanisms, and discuss their clinical features and treatment strategies.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3110901PMC
http://dx.doi.org/10.4330/wjc.v3.i5.127DOI Listing

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