Key result
Pseudo-LBBB wide QRS tachycardia signals RV VT, prompting investigation for ARVC.
Why the study?
Regular, wide QRS tachycardia is usually ventricular tachycardia even in young people, but differentiation from supraventricular tachycardia with bundle branch block remains important.
Case Report (n=1)
Regular wide QRS tachycardia in a young patient should be presumed to be ventricular tachycardia, and pseudo LBBB morphology requires investigation for ARVC.
May support presuming ventricular tachycardia in young patients with this ECG pattern; hypothesis-generating for ARVC links pending larger cohorts.
Regular, wide QRS tachycardia is usually VT, even in young people. QRS morphology is the key to differentiating VT from SVT with bundle branch block. P-waves may help to distinguish VT from pre-excited tachycardias. VT from the right ventricle (pseudo LBBB morphology) requires investigation for ARVC.
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Rob Scott Millar (2017) conducted a case report in Wide QRS tachycardia / Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) (n=1). Electrocardiography was evaluated. Detailed ECG analysis of a regular wide QRS tachycardia with pseudo LBBB morphology in a young patient indicates ventricular tachycardia from the right ventricle, requiring investigation for ARVC.
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