McGill Case 240

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This case report is kindly provided by Michael Rosengarten from McGill and is part of the McGill Cases. These cases come from the McGill EKG World Encyclopedia.

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The recording is interesting as the patient goes from sinus rhythm to at first a wide complex tachycardia at about 130/min. The wide QRS though disappears after nine complexes and is replaced by narrow complexes at a slightly slower rate. No p wave activity is seen. This a supraventricular tachycardia with a from of abberancy. In this case we are probably seeing a rate dependent left bundle branch block or the effect of a left bundle branch block which persists for the nine complexes because of continued block in the left bundle from the depolarizations from the intact right bundle.