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Challenges in Clinical Electrocardiography
July 19, 2021

Diagnostic Approach to Wide Complex Tachycardia

Author Affiliations
  • 1Electrophysiology Section, Cardiovascular Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
JAMA Intern Med. 2021;181(9):1231-1233. doi:10.1001/jamainternmed.2021.3189

A woman in her 60s with melanoma metastatic to the mediastinum presented with intermittent palpitations and light-headedness. On physical examination, the patient was anxious and tachycardic. A 12-lead electrocardiogram (ECG) was performed (Figure, A).

Questions: Is this wide complex tachycardia ventricular tachycardia (VT) or supraventricular tachycardia (SVT) with aberrant conduction? What features on the ECG can be used to distinguish these causes?

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