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JAMA Cardiology Clinical Challenge
January 27, 2021

Unusual Wide QRS Complex Rhythm in a Teenager

Author Affiliations
  • 1Electrophysiology Unit, Clinique Pasteur, Toulouse, France
  • 2Pediatric and Adult Congenital Heart Disease Department, Clinique Pasteur, Toulouse, France
  • 3Pediatric and Adult Congenital Heart Disease Department, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
  • 4Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France
  • 5Adult Congenital Heart Disease Unit, European Georges Pompidou Hospital, Paris, France
  • 6Pediatric and Congenital Heart Disease Department, Necker Hospital, Paris, France
JAMA Cardiol. Published online January 27, 2021. doi:10.1001/jamacardio.2020.7091

A teenaged girl presented with recurrent episodes of chest and neck palpitations accompanied by headaches for 3 years, with sudden onset and offset. She had no specific medical or family history and had no treatment. A resting electrocardiogram (ECG) while symptomatic showed a wide QRS complex rhythm at a rate of 81 beats per minute (Figure 1A). After a short walk, symptoms disappeared and another ECG was recorded (Figure 1B). Physical examination and transthoracic echocardiography results were normal.

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