As mentioned in the previous case of 68 years old male who presented with tiredness, sweating chest, uneasiness. ( Click here ) First thing comes to mind is differential diagnosis as you all thought- simple anxiety, pulmonary embolism, RBBB, AF, VT, SVT etc. When you analyze ECG it looks like RBBB regular RR intervals HR 162/min. Still, you go, zoom & see QRS complex is not preceded by P waves. When QRS complex is analyzed, P waves are deforming later part of QRS suggestive of retrograde conduction.
Due to RBBB, we diagnosed it as a case of PSVT- AV Nodal Re-entry Tachycardia with aberrant conduction. ] The patient responded well to IV Adenosine 6 mg bolus and reverted to NSR with RBBB. He has pre-existing RBBB. We went ahead with EPS, induced SVT, assessed pathways and radiofrequency ablation are done successfully and reconfirmed by failure to reinduce. Due to his history of uneasiness…
