A 60 yo with h/o HTN c/o SOB. What is the rhythm?
Image 1
This is a regular narrow complex tachycardia (NCT) at rate of about 167 bpm. P waves are inverted in II, III and aVF and upright in AVR. The PR interval is shorter compared to the RP interval. So, this is a regular narrow complex long RP tachycardia.
The differential diagnosis for long RP tachycardia with inverted P waves in the inferior leads are:
- atrial tachycardia
- atypical AV nodal reentry tachycardia (AVNRT)
- persistent form of junctional reciprocating junctional tachycardia (PJRT)
- junctional tachycardia
Reference:
Das and Zipes. 2012. Electrocardiography of arrhythmias : a comprehensive review. Elsevier PA
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