A 61-Year-Old Patient with Activity-Related Wide Complex Tachycardia

[摘要] A 61-year-old man with no known cardiac disease developed palpitations and diaphoresis while moving boxes. He drove himself to the local emergency room, where he was found to have wide complex tachycardia, showing a left bundle branch block (LBBB) morphology and inferior axis (Fig. 1). Shortly after arrival, his tachycardia degenerated into ventricular fibrillation requiring external defibrillation. He was given intravenous lidocaine and amiodarone for recurrent ventricular tachycardia (VT) and was transferred to our institution. Laboratory evaluation showed serum electrolytes to be within normal values. A resting electrocardiogram (ECG) obtained 3 days later is presented as well (Fig. 2).