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Algul E, Merovci I, Kara M, Cetin EHO, Kocyigit Burunkaya D, Sunman H, Korkmaz A, Ozcan F, Cay S, Ozeke O, Ozdemir O, Aras D, Topaloglu S. A Wide QRS Complex Tachycardia with Variation of Ventriculoatrial Interval: What is the Mechanism? J Innov Card Rhythm Manag 2025; 16:6173-6176. [PMID: 40052010 PMCID: PMC11882115 DOI: 10.19102/icrm.2025.16021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 08/24/2024] [Indexed: 03/09/2025] Open
Abstract
The differential diagnosis for wide complex tachycardia includes all causes of narrow complex tachycardia with bundle branch block, all causes of narrow complex tachycardia with antegrade pre-excitation, ventricular tachycardia, and antidromic and other pre-excited reciprocating tachycardias. The variation in a specific intracardiac interval that causes a subsequent change in the tachycardia cycle length or another intracardiac interval can be diagnostic in these arrhythmias.
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Affiliation(s)
- Engin Algul
- Department of Cardiology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Idriz Merovci
- Department of Cardiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Meryem Kara
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Duygu Kocyigit Burunkaya
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Hamza Sunman
- Department of Cardiology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Ozcan Ozdemir
- Department of Cardiology, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, İstanbul Medipol University, İstanbul, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey
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Kara M, Ozcan Cetin EH, Kocyigit Burunkaya D, Merovci I, Kus G, Can ID, Aksoy A, Korkmaz A, Ozcan F, Cay S, Ozeke O, Aras D, Topaloglu S. Wide complex tachycardia with negative precordial concordance: All that glitters is not gold. J Cardiovasc Electrophysiol 2024; 35:1033-1037. [PMID: 38454560 DOI: 10.1111/jce.16239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Meryem Kara
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Duygu Kocyigit Burunkaya
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Idriz Merovci
- Department of Cardiology, University Clinical Center of Kosovo, Prishtina, Kosovo
| | - Gorkem Kus
- Department of Cardiology, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
| | - Irem Dilara Can
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Atik Aksoy
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, İstanbul Medipol University, İstanbul, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Turkey
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Aslan AO, Merovci I, Tunçez A, Oksuz F, Al EA, Kara M, Cetin EHO, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Widening of the QRS complex during the wide complex tachycardia: What is the mechanism? J Cardiovasc Electrophysiol 2022; 33:1605-1608. [PMID: 35671328 DOI: 10.1111/jce.15567] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/27/2022]
Abstract
Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmet Oguz Aslan
- Health Sciences University, Ahi Evren Thoracic, and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Idriz Merovci
- University Clinical Center of Kosovo, Department of Cardiology, Prishtina, Kosovo
| | | | - Fatih Oksuz
- Health Sciences University, Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Ertan Andac Al
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Meryem Kara
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Aslan AO, Merovci I, Tunçez A, Oksuz F, Kara M, Cetin EHO, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Simultaneous narrow and wide QRS complex tachycardia: Misdiagnosis or Missed diagnosis? J Cardiovasc Electrophysiol 2022; 33:1599-1604. [PMID: 35612357 DOI: 10.1111/jce.15560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/17/2022] [Accepted: 05/22/2022] [Indexed: 11/30/2022]
Abstract
Tachycardia-induced tachycardia, or so-called double tachycardia, appears to be a relatively rare condition. Regardless of the mechanism, this case illustrates the importance of assessing the response to multiple different pacing maneuvers in determining the mechanism of narrow and wide QRS complex tachycardias, rather than relying upon a single maneuver, even one that is believed to be diagnostic. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmet Oguz Aslan
- Health Sciences University, Ahi Evren Thoracic and Cardiovascular Surgery Training and Research Hospital, Trabzon, Turkey
| | - Idriz Merovci
- University Clinical Center of Kosovo, Department of Cardiology, Prishtina, Kosovo, Turkey
| | | | - Fatih Oksuz
- Health Sciences University, Ankara Education and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Meryem Kara
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- Health Sciences University, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Tuncez A, Merovci I, Efe TH, Kara M, Deveci B, Cetin EHO, Korkmaz A, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Transition from Two Wide to A Narrow QRS Complex Tachycardia: What is the mechanism of tachycardia and transition? J Cardiovasc Electrophysiol 2022; 33:1316-1319. [PMID: 35362173 DOI: 10.1111/jce.15479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/28/2022] [Accepted: 03/30/2022] [Indexed: 10/18/2022]
Abstract
Spontaneous transition from one tachycardia to another tachycardia poses a challenge to the electrophysiologists and most likely occurs by multiple mechanisms. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Idriz Merovci
- University Clinical Center of Kosovo, Department of Cardiology, Prishtina, Kosovo, Turkey
| | - Tolga Han Efe
- University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Cardiology, Ankara, Turkey
| | - Meryem Kara
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Bulent Deveci
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Elif Hande Ozcan Cetin
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ahmet Korkmaz
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Ozcan Ozeke
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Serkan Cay
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Firat Ozcan
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
| | - Dursun Aras
- İstanbul Medipol University, Department of Cardiology, İstanbul, Turkey
| | - Serkan Topaloglu
- University of Health Sciences, Ankara City Hospital, Department of Cardiology, Ankara, Turkey
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Deveci B, Kara M, Korkmaz A, Ozeke O, Cay S, Ozcan F, Topaloglu S, Aras D. A Wide QRS Tachycardia with Three Distinct Left Bundle Branch Block Morphologies in a Patient with Sinus Rhythm with Left Bundle Branch Block: What Is the Mechanism? J Innov Card Rhythm Manag 2021; 12:4744-4748. [PMID: 34712509 PMCID: PMC8545438 DOI: 10.19102/icrm.2021.121007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/31/2021] [Indexed: 11/06/2022] Open
Abstract
The differential diagnosis for a wide complex tachycardia includes all causes of supraventricular tachycardia (SVT) with bundle branch block or all causes of SVT with antegrade pre-excitation by bystander involvement of any accessory pathways, myocardial or bundle brunch ventricular tachycardia, and antidromic (atriofascicular or nodofascicular/nodoventricular) and other pre-excited reciprocating tachycardias. We present a case of wide complex QRS tachycardia with a left bundle branch block QRS morphology.
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Affiliation(s)
- Bulent Deveci
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Meryem Kara
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Korkmaz A, Kara M, Ozeke O, Cay S, Ozcan F, Topaloglu S, Aras D. Termination, Advancement, and Delaying Responses to His Synchronous Premature Ventricular Contractions During Narrow QRS Tachycardia: What Are the Possible Mechanisms? J Innov Card Rhythm Manag 2021; 12:4376-4380. [PMID: 33520354 PMCID: PMC7834043 DOI: 10.19102/icrm.2021.120108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 09/22/2020] [Indexed: 12/13/2022] Open
Abstract
The differential diagnosis of a regular, narrow QRS, long-R-P tachycardia includes atypical atrioventricular nodal reentry tachycardia, atrial tachycardia, and atrioventricular reentry tachycardia via a slowly conducting accessory pathway with decremental conduction properties. Almost all described diagnostic maneuvers in the electrophysiology laboratory have exceptions to their primary interpretation. The usual proviso is that the observation must be reproducible.
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Affiliation(s)
- Ahmet Korkmaz
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Meryem Kara
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Cay
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
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Erratum. J Cardiovasc Electrophysiol 2020. [DOI: 10.1111/jce.14818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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