LBBB-Like VT in Patient with RBBB

Report:

Ventricular tachycardia 178/min

LBBB morphology with left axis deviation

Comment:

Lead V1 has a broad primary R wave (0.04”), distinguishing the ectopic morphology from LBBB conduction. Also, the patient’s basic conduction is RBBB (shown in Case 24). While not precluding LBBB aberrancy, pre-existing RBBB is strongly against it, as discussed with the same patient’s VT (that one with right axis deviation) in Case 24. Her sinus rhythm is shown again below, Fig 92a).

Left axis deviation is not, per se, a criterion for VT. It is mentioned here, like the foramen secundum ASD, to give opportunity to those in the know about these things to show it.

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