Editorial
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. May 26, 2011; 3(5): 127-134
Published online May 26, 2011. doi: 10.4330/wjc.v3.i5.127
Differential diagnosis of tachycardia with a typical left bundle branch block morphology
Jeffrey S Neiger, Richard G Trohman
Jeffrey S Neiger, Richard G Trohman, Department of Medicine, Section of Cardiology, Clinical Cardiac Electrophysiology Service, Rush University Medical Center, Chicago, IL 60612, United States
Author contributions: Neiger JS and Trohman RG contributed solely to this paper.
Correspondence to: Richard G Trohman, MD, Department of Medicine, Section of Cardiology, Clinical Cardiac Electrophysiology Service, Rush University Medical Center, 1750 W. Harrison St., Suite 983 Jelke, Chicago, IL 60612, United States. rtrohman@rush.edu
Telephone: +1-312-9426858 Fax: +1-312-9425862
Received: March 12, 2011
Revised: April 13, 2011
Accepted: April 20, 2011
Published online: May 26, 2011
Abstract

The evaluation of wide QRS complex tachycardias (WCT) remains a common dilemma for clinicians. Numerous algorithms exist to aid in arriving at the correct diagnosis. Unfortunately, these algorithms are difficult to remember, and overreliance on them may prevent cardiologists from understanding the mechanisms underlying these arrhythmias. One distinct subcategory of WCTs are those that present with a “typical” or “classic” left bundle branch block pattern. These tachycardias may be supraventricular or ventricular in origin and arise from functional or fixed aberrancy, bystander or participating atriofascicular pre-excitation, and bundle branch reentry. This review will describe these arrhythmias, illustrate their mechanisms, and discuss their clinical features and treatment strategies.

Keywords: Typical left bundle branch block, Wide complex tachycardia, Bundle branch reentrant ventricular tachycardia