ABC of clinical electrocardiography: Broad complex tachycardia---Part II

doi:10.1136/bmj.324.7340.776

BMJ 2002;324:776-779 ( 30 March )

Clinical review

ABC of clinical electrocardiography

Broad complex tachycardia $---$ Part II

June Edhouse, Francis Morris.

The first 150 words of the full text of this article appear below.

This article continues the discussion, started last week, on ventricular tachycardias and also examines how to determine whethera broad complex tachycardia is ventricular or supraventricularin origin.

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Ventricular tachycardias

Fascicular tachycardia
Fascicular tachycardia is uncommon and notusually associated with underlying structural heart disease. Itoriginates from the region of the posterior fascicle (or occasionallythe anterior fascicle) of the left bundle branch and is partlypropagated by the His-Purkinje network. It therefore producesQRS complexes of relatively short duration (0.11-0.14 s). Consequently,this arrhythmia is commonly misdiagnosed as a supraventriculartachycardia.

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The QRS complexes have a right bundle branch block pattern, often with a small Q wave rather than primary R wave in lead V1and a deep S wave in lead V6. When the tachycardia originatesfrom the posterior fascicle the frontal plane axis of the QRScomplex is deviated to the left; when it originates from the anteriorfascicle, . . . [Full text of this article]

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