Electrocardiographical case. A case of wide complex tachycardia

D Foo, KS Ng
Correspondence: Dr David Foo, david_foo@ttsh.com.sg

ABSTRACT
A 43-year-old Chinese woman complained of a one week history of irregular rapid palpitations associated with chest discomfort and dyspnoea. Her heart rate was more than 160 beats per minute and blood pressure was 154/95 mmHg. 12-lead electrocardiogram (ECG) showed a wide complex tachycardia with a slightly irregular rhythm. Delta waves were also present. She was treated appropriately with intravenous procainamide but developed torsades de pointes secondary to prolonged QT interval. Electrophysiology study revealed atrial tachycardia with a left-sided accessory pathway which was successfully ablated.

Keywords: accessory pathway, long QT, procainamide, wide complex tachcardia, Wolff-Parkinson-White syndrome
Singapore Med J 2005; 46(5): 245-249