KMID : 1011920090100010029
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International Journal of Arrhythmia 2009 Volume.10 No. 1 p.29 ~ p.30
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Oh Se-Il
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Abstract
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A 32-year-old woman with acute myelogenous leukemia was referred to arrhythmia service to evaluate her palpitation. Electrocardiogram (ECG) recorded during palpitation showed wide QRS tachycardia with alternating cycle length. The QRS axis was northwest and the morphology of the QRS complex was not typical RBBB pattern. These findings constellated that this wide QRS tachycardia was ventricular origin. Cardiac magnetic resonance imaging (MRI) showed multiple myocardial masses and one of them was located at the apical inferolateral wall of the left ventricle, which could be associated with this tachycardia. Ventricular tachycardia with alternating cycle length could be explained with one of the following mechanisms. This phenomenon could result from the firing of regular automatic focus with either 3:2 exit block of the Wenckebach type or with alternating exit conduction times.
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KEYWORD
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ventricular tachycardia, alternating cycle length, electrocardiogram
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