Images in cardiology: ventriculo-atrial Wenckebach during wide complex tachycardia.

摘要

A 35-year-old woman became hypotensive two days after undergoing resection of a spinal tumor. The electrocardiogram (ECG) showed wide complex tachycardia. Ventriculo-atrial (V-A) Wenckebach was noted in lead II with retrograde P waves and gradual prolongation of the R-P interval until a ventricular complex was not followed by a retrograde P wave (Fig. 1).In a study of 253 patients with wide complex tachycardia who underwent electrophysiologic testing, and of whom 23 had V-A conduction,1 only two had V-A Wenckebach. Ventriculo-atrial Wenckebach is not commonly seen in the surface ECG during a wide complex tachycardia. When present, it points to the ventricles as the origin of the arrhythmia.