Sol dal blok sol aks morfolojili taşikardi olgusu

Taşiaritmilerin doğru tanı ve tedavisi hayati öneme sahiptir. Geniş QRS kompleks taşikardilerin doğru tanısı bazen ciddi sıkıntılara yol açabilmektedir. Biz bu yazıda çarpıntı esnasında alınan yüzey EKG kaydında sol dal bloğu ve sol aks morfolojili geniş QRS kompleksler saptanan, ayrıca persistan sol superior vena kava varlığı ile komplike olan olgunun ayrıcı tanısı ve tedavisini sunmayı hedefledik.

A case of tachycardia with left bundle branch block and left axis deviation

Accurate diagnosis of tachyarrhythmias is of vital importance for correct management. Diagnosis of wide QRS complex tachycardias sometimes pose serious difficulties. We aimed to present the differential diagnosis and ablative treatment of a young man with a wide QRS complex tachycardia with left bundle branch block pattern and left axis deviation, further complicated by the presence of a persistent vena cava superior.

___

  • 1) Sager PT, Bhandari AK. Wide complex tachycardias. Differential diagnosis and management. Cardiol Clinic1991; 9: 595-618.
  • 2) Gonzalez-Juanatey C, Testa A, Vidan J, Izquierdo R, Garcia-Castelo A, Daniel C, Armesto V. Persistent left superior vena cava draining into the coronary sinus: report of 10 cases and literature review. Clin Cardiol. 2004; 27: 515-518.
  • 3) Baerman JM, Morady F, DiCario LA, de Buitleir M. Differentiation of ventricular tachycardia from supraventricular tachycardia with aberration: value of the clinical history. Ann Emerg Med 1991; 9: 592-597.
  • 4) Tchou P, Young P, Mahmud R, et al. Useful clinical criteria for the diagnosis of ventricular tachycardia. Am J Med 1988; 84: 53-56.
  • 5) Vereckei A, Duray G, Szénási G, Altemose GT, Miller JM. New algorithm using only lead aVR for differential diagnosis of wide QRS complex tachycardia. Heart Rhythm 2008; 5: 89-98.
  • 6) Kurşaklıoğlu H, Köse S, Barçın C, Iyisoy A, Işık E. Demirtaş E. Radiofrequency catheter ablation of a left lateral accessory pathway in a patient with persistent left superior vena cava. Heart Dis 2002; 4: 162-165.