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Challenges in Clinical Electrocardiography
December 2014

The Importance of the Ladder Diagram in the Evaluation of Tachyarrhythmia: Jumping to Conclusions

Author Affiliations
  • 1Division of Cardiology, University of Iowa Hospitals and Clinics, Iowa City
JAMA Intern Med. 2014;174(12):2024-2026. doi:10.1001/jamainternmed.2014.5231

A 64-year-old white woman presented to the emergency department for evaluation of episodic palpitations and chest tightness. On arrival to the emergency department, her symptoms had entirely resolved. A 12-lead electrocardiogram (ECG) was obtained while she was asymptomatic and is shown in Figure 1A. Minutes later, the patient developed recurrence of her symptoms with palpitations, chest tightness, and dyspnea. A 12-lead ECG captured this event and is shown in Figure 1B.

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