A Young Man With Wide Complex Tachycardia—The Devil Is in the Details

Abstract

A man in his 20s presented to the emergency department with complaints of intermittent palpitations for 2 days, which had worsened in the previous hour. He had no history of chest pain, dyspnea, congestion, or fever. There was no past cardiac history or family history of similar complaints. On presentation, the patient's blood pressure was 110/72 mm Hg, and respiratory rate was 14 bpm. On examination, results of cardiovascular system checks were unremarkable. A 12-lead electrocardiogram (ECG) (Figure , A) was obtained. The patient was given intravenous amiodarone, which was followed by conversion into sinus rhythm (Figure , B).Question: According to this patient's ECG results, what is the most likely diagnosis, and how would you treat the patient? Interpretation