Voir la suite de cet article sur Cursus ECG
Patient
42-year-old man followed by his cardiologist for evidence of ventricular extrasystoles; sensations of palpitations occurring during recovery after physical exertion;
Trace
This electrocardiogram suggests the presence of ventricular extrasystoles originating from the right ventricular infundibulum (left delay, wide R waves in the inferior branches, relatively late transition R/S>1 in V4) without severity criteria (monomorphic and narrow extrasystoles, basal electrocardiogram without signs suggestive of arrhythmogenic right ventricular dysplasia);
Trace
A complete assessment is performed (cardiac ultrasound, ventricular late potentials, exercise test, MRI) without any detected abnormality; an isoproterenol test is performed: during recovery, sinus tachycardia followed by tachycardia of 200 bpm with a morphology identical to extrasystoles; clinical reproduction of symptomatology experienced by the patient at the time of palpitations; preserved hemodynamics and spontaneous termination after 20 seconds of tachycardia;
Exergue
An infundibular ventricular tachycardia occurs preferentially in a young patient without heart disease with a characteristic electrocardiographic pattern: monomorphic tachycardia, slightly widened QRS, left delay and inferior axis, atrioventricular dissociation. A late precordial transition (R/S > 1) (in leads V3, V4 or V5) is suggestive of a right ventricular infundibular origin.
this patient hence presented episodes of right infundibular ventricular tachycardia. This type of tachycardia is considered to be benign and classically observed in young patients, aged 20 to 40 years on average, devoid of heart disease, without male or female predominance.