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Vol. 71. Issue 4.
Pages 294 (April 2018)
ECG Contest
DOI: 10.1016/j.rec.2017.10.042
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ECG, April 2018
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José Amador Rubio
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jarucab@gmail.com

Corresponding author:
, Pablo Robles, Elena Magallanes-Ribeiro
Unidad de Cardiología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
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Rev Esp Cardiol. 2018;71:39510.1016/j.rec.2017.12.004
José Amador Rubio, Pablo Robles, Elena Magallanes-Ribeiro
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Full English text available from: www.revespcardiol.org/en

A 58-year-old man presented to his health center with palpitations and dyspnea. He had a history of an old inferior myocardial infarction and 8 months earlier he had had an anterior infarction. An ECG was performed (Figure 1) and, according to the notes, 300 mg amiodarone was given intravenously. The tachycardia persisted and the patient became hemodynamically unstable. Electric cardioversion was then performed with 100-J discharges. Figure 2 shows the rhythm strip obtained with the defibrillator paddles.

Figure 1
(0.37MB).
Figure 2
(0.18MB).

In your opinion, which is the correct answer regarding these traces?

  • 1.

    There is an initial R wave in aVR; it is supraventricular tachycardia.

  • 2.

    There is a 1:1 atrial-ventricular rate; this confirms a diagnosis of supraventricular tachycardia.

  • 3.

    The rhythm strip (post-intravenous amiodarone) supports a diagnosis of ventricular tachycardia.

  • 4.

    The electrical cardioversion was effective.

Submit your answer to this ECG Challenge at http://www.revespcardiol.org/en/electroreto/71/04. The solution will be published in the next issue (May 2018). #ECGContest.

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