Mechanisms of regular, wide QRS tachycardia in infants and children

D. Woodrow Benson, Warren M. Smith, Ann Dunnigan, Richard Sterba, John J. Gallagher

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

A regular, wide QRS tachycardia was electrocardiographically documented in 32 patients aged 1 month to 18 years. The mechanisms of the tachycardia were evaluated using standard multicatheter electrophysiologic techniques. These mechanisms included (1) orthodromic reciprocating tachycardia with bundle branch aberration (seven patients), (2) antidromic reciprocating tachycardia using single (three patients), or multiple (three patients) atrioventricular connections (Kent bundles), (3) atrial flutter with ventricular preexcitation over accessory connections (eight patients), (4) reciprocating tachycardia using a nodoventricular connection (Mahaim fiber) (five patients), and (5) ventricular tachycardia (six patients). Regular, wide QRS tachycardias are not rare in pediatric patients. Their mechanisms can be quite complex, and electrocardiographic analysis with respect to QRS configuration, heart rate, or the presence or absence of ventriculoatrial dissociation is not sufficient for diagnostic purposes. Our results show that considerable understanding of the mechanism of regular, wide QRS tachycardias can be obtained by multicatheter electrophysiologic study. Understanding the mechanism is essential in order to make rational use of available therapeutic options.

Original languageEnglish (US)
Pages (from-to)1778-1788
Number of pages11
JournalThe American Journal of Cardiology
Volume49
Issue number7
DOIs
StatePublished - May 1982

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Tachycardia
Reciprocating Tachycardia
Accessory Atrioventricular Bundle
Atrial Flutter
Therapeutic Uses
Ventricular Tachycardia
Heart Rate
Pediatrics

Cite this

Benson, D. W., Smith, W. M., Dunnigan, A., Sterba, R., & Gallagher, J. J. (1982). Mechanisms of regular, wide QRS tachycardia in infants and children. The American Journal of Cardiology, 49(7), 1778-1788. https://doi.org/10.1016/0002-9149(82)90259-4

Mechanisms of regular, wide QRS tachycardia in infants and children. / Benson, D. Woodrow; Smith, Warren M.; Dunnigan, Ann; Sterba, Richard; Gallagher, John J.

In: The American Journal of Cardiology, Vol. 49, No. 7, 05.1982, p. 1778-1788.

Research output: Contribution to journalArticle

Benson, DW, Smith, WM, Dunnigan, A, Sterba, R & Gallagher, JJ 1982, 'Mechanisms of regular, wide QRS tachycardia in infants and children', The American Journal of Cardiology, vol. 49, no. 7, pp. 1778-1788. https://doi.org/10.1016/0002-9149(82)90259-4
Benson, D. Woodrow ; Smith, Warren M. ; Dunnigan, Ann ; Sterba, Richard ; Gallagher, John J. / Mechanisms of regular, wide QRS tachycardia in infants and children. In: The American Journal of Cardiology. 1982 ; Vol. 49, No. 7. pp. 1778-1788.
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