{"id":9971,"date":"2015-11-15T07:43:47","date_gmt":"2015-11-15T02:13:47","guid":{"rendered":"http:\/\/cardiophile.org\/?p=4662"},"modified":"2015-11-15T07:43:47","modified_gmt":"2015-11-15T02:13:47","slug":"svt-with-rbbb-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/","title":{"rendered":"SVT with RBBB"},"content":{"rendered":"<h2><span style=\"color: #008000;\">Supraventricular tachycardia with RBBB pattern<\/span><\/h2>\n<p><iframe loading=\"lazy\" width=\"560\" height=\"315\" src=\"https:\/\/www.youtube.com\/embed\/Nq205Tr-Yp0\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen=\"\"><\/iframe><\/p>\n<p>SVT with RBBB (supraventricular tachycardia with right bundle branch block) pattern as evidenced by the slurred S wave in lead I and aVL and rSR&#8217; pattern in V1. The&nbsp; right bundle conduction is slower during tachycardia and hence right bundle aberrancy is more likely to occur than left bundle aberrancy. It could also be a pre-existing right bundle branch block. In this case the person had Ebstein&#8217;s anomaly of tricuspid valve. Ebstein&#8217;s anomaly can be associated with RBBB pattern or polyphasic QRS complexes. They can also have right sided accessory pathways which can predispose to atrioventricular reentrant tachycardia.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-31648 size-full\" src=\"https:\/\/johnsonfrancis.org\/professional\/wp-content\/uploads\/2015\/11\/SVT-with-RBBB1.jpg\" alt=\"\" width=\"1500\" height=\"689\"><\/p>\n<p>Supraventricular tachycardia with aberrant conduction can be mistaken for ventricular tachycardia due to the wide QRS complex. But a typical right bundle branch block pattern in multiple leads as seen in this case of SVT with RBBB&nbsp;is unlikely in ventricular tachycardia.<\/p>\n<p>12 lead ECG is useful in differentiating SVT with RBBB (or other form of aberrancy) from ventricular tachycardia [1]. But it may be difficult to differentiate in case of fast tachycardias with rate above 190\/min. Presence of AV dissociation, if visible on the ECG would point towards ventricular tachycardia.<\/p>\n<p>It is always better to consider a wide QRS tachycardia as ventricular tachycardia until proved otherwise as 80% of wide QRS tachycardias are likely to of ventricular origin [2]. This approach would avoid potential delays and dangers due to delayed diagnosis of a life threatening ventricular tachycardia.<\/p>\n<p style=\"text-align: left;\"><span style=\"color: #0000ff;\"><strong>References<\/strong><\/span><\/p>\n<ol>\n<li style=\"text-align: left;\">Drew BJ, Scheinman MM. <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/8771133\">ECG criteria to distinguish between aberrantly conducted supraventricular tachycardia and ventricular tachycardia: practical aspects for the immediate care setting<\/a>.&nbsp;Pacing Clin Electrophysiol. 1995 Dec;18(12 Pt 1):2194-208.<\/li>\n<li style=\"text-align: left;\">Levy S. Differentiating SVT from VT&#8211;a personal viewpoint.&nbsp;Eur Heart J. 1994 Apr;15 Suppl A:31-8.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>ECG demonstrating SVT with RBBB.<\/p>\n","protected":false},"author":1,"featured_media":31648,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[6,7],"tags":[3236,3788],"class_list":["post-9971","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ecg-electrophysiology","category-ecg-library","tag-rbbb","tag-supraventricular-tachycardia"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>SVT with RBBB (Supraventricular tachycardia with RBBB)<\/title>\n<meta name=\"description\" content=\"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"SVT with RBBB (Supraventricular tachycardia with RBBB)\" \/>\n<meta property=\"og:description\" content=\"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/\" \/>\n<meta property=\"og:site_name\" content=\"All About Cardiovascular System and Disorders\" \/>\n<meta property=\"article:published_time\" content=\"2015-11-15T02:13:47+00:00\" \/>\n<meta name=\"author\" content=\"Johnson Francis\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Johnson Francis\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"1 minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/\"},\"author\":{\"name\":\"Johnson Francis\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"headline\":\"SVT with RBBB\",\"datePublished\":\"2015-11-15T02:13:47+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/\"},\"wordCount\":291,\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"keywords\":[\"RBBB\",\"Supraventricular tachycardia\"],\"articleSection\":[\"ECG \\\/ Electrophysiology\",\"ECG Library\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/\",\"name\":\"SVT with RBBB (Supraventricular tachycardia with RBBB)\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#primaryimage\"},\"thumbnailUrl\":\"\",\"datePublished\":\"2015-11-15T02:13:47+00:00\",\"description\":\"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#primaryimage\",\"url\":\"\",\"contentUrl\":\"\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/svt-with-rbbb-2\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"SVT with RBBB\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#website\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/\",\"name\":\"All About Cardiovascular System and Disorders\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":[\"Person\",\"Organization\"],\"@id\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/#\\\/schema\\\/person\\\/5441d907049b914770f4bd98fb57feec\",\"name\":\"Johnson Francis\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\",\"caption\":\"Johnson Francis\"},\"logo\":{\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g\"},\"description\":\"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal\",\"url\":\"https:\\\/\\\/johnsonfrancis.org\\\/professional\\\/author\\\/jf\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"SVT with RBBB (Supraventricular tachycardia with RBBB)","description":"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/","og_locale":"en_US","og_type":"article","og_title":"SVT with RBBB (Supraventricular tachycardia with RBBB)","og_description":"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.","og_url":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/","og_site_name":"All About Cardiovascular System and Disorders","article_published_time":"2015-11-15T02:13:47+00:00","author":"Johnson Francis","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Johnson Francis","Est. reading time":"1 minute"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#article","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/"},"author":{"name":"Johnson Francis","@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"headline":"SVT with RBBB","datePublished":"2015-11-15T02:13:47+00:00","mainEntityOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/"},"wordCount":291,"publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#primaryimage"},"thumbnailUrl":"","keywords":["RBBB","Supraventricular tachycardia"],"articleSection":["ECG \/ Electrophysiology","ECG Library"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/","url":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/","name":"SVT with RBBB (Supraventricular tachycardia with RBBB)","isPartOf":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#website"},"primaryImageOfPage":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#primaryimage"},"image":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#primaryimage"},"thumbnailUrl":"","datePublished":"2015-11-15T02:13:47+00:00","description":"ECG demonstrating SVT with RBBB (Supraventricular tachycardia with right bundle branch block). SVT with RBBB can be mistaken for ventricular tachycardia.","breadcrumb":{"@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#primaryimage","url":"","contentUrl":""},{"@type":"BreadcrumbList","@id":"https:\/\/johnsonfrancis.org\/professional\/svt-with-rbbb-2\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/johnsonfrancis.org\/professional\/"},{"@type":"ListItem","position":2,"name":"SVT with RBBB"}]},{"@type":"WebSite","@id":"https:\/\/johnsonfrancis.org\/professional\/#website","url":"https:\/\/johnsonfrancis.org\/professional\/","name":"All About Cardiovascular System and Disorders","description":"","publisher":{"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/johnsonfrancis.org\/professional\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":["Person","Organization"],"@id":"https:\/\/johnsonfrancis.org\/professional\/#\/schema\/person\/5441d907049b914770f4bd98fb57feec","name":"Johnson Francis","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g","caption":"Johnson Francis"},"logo":{"@id":"https:\/\/secure.gravatar.com\/avatar\/80861b82c3f559be9e413245c5643b6c483c93495507facfe32cf96ccd8bcffd?s=96&d=mm&r=g"},"description":"Former Professor of Cardiology, Calicut Govt. Medical Kozhikode, Kerala, India. Editor-in-Chief, BMH Medical Journal","url":"https:\/\/johnsonfrancis.org\/professional\/author\/jf\/"}]}},"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/9971","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/comments?post=9971"}],"version-history":[{"count":0,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/posts\/9971\/revisions"}],"wp:attachment":[{"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/media?parent=9971"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/categories?post=9971"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/johnsonfrancis.org\/professional\/wp-json\/wp\/v2\/tags?post=9971"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}