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Left bundle branch block in alternate beats during fast-slow atrioventricular nodal reentrant tachycardia

Merlino, A.; Iudicello, M.S.; Di Stefano, G.

Giornale Italiano di Cardiologia 9(11): 779-782

2008

ISSN/ISBN: 1827-6806
PMID: 19058671
Document Number: 618978
The presented ECG shows a fast-slow atrioventricular nodal reentrant tachycardia with regular alternation of narrow and wide beats. The wide QRS complexes have a typical configuration of left bundle branch block. Alternation of narrow and wide beats during supraventricular tachycardia is an uncommon finding. It can be due to several mechanisms. The analysis of the ECG demonstrates that the bundle branch block is tachycardia-dependent or phase 3. Supernormal left bundle branch conduction associated with a retrograde concealed conduction into the anterogradely blocked bundle branch helps explain this phenomenon.

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