Paediatric ECG of the Week Archive

ECG Answer for ~ November 4th 2017

Narrow Complex Tachycardia. Ventricular Rate 300/min. QRS axis:+120
PR: 80ms RP: 120ms QRS: 70ms QT/QTc: 260/380
Imp: Long RP reentrant tachycardia


Comment: Narrow complex tachycardia: narrow QRS, ventricular rate 300;
The differential diagnosis of narrow complex tachycardia at this rate in the neonate is: Re-entrant SVT, Atrial flutter, Ectopic Atrial Tachycardia. In this tracing one first might consider that this is atrial flutter, however distinct p waves are visible in the preceding T wave (best seen in the praecordial leads) with a long RP interval. Adenosine, which will either convert this rhythm to sinus or expose the underlying atrial flutter, can easily make the correct diagnosis

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