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The missing P waves in wide QRS tachycardia

Year: 2026

Type: article

Abstract: A 57-year-old male patient presented with paroxysmal palpitations for 2 years. The patient's blood pressure was 120/76 mmHg; his heart rate was 149 beats/min. The presenting electrocardiogram showed a wide QRS complex tachycardia with an irregular rhythm. The RR intervals were irregular, and there were more complex QRS waves than P waves. The patient was first diagnosed with ventricular tachycardia. The ECG during sinus rhythm revealed a complete right bundle-branch block. The patient underwent an invasive electrophysiological study and was then diagnosed with atrioventricular nodal reentrant tachycardia (AVNRT). Following successful slow pathway radiofrequency ablation (located at the anterior part of the coronary sinus ostium), tachycardia was no longer inducible.

Source: Frontiers in Physiology

DOI: 10.3389/fphys.2025.1732486

Authors: Jiangying Mo, Xuan Jiang, Shuang Zhang, Xuping Li, Mingxian Chen

Institution: Second Xiangya Hospital of Central South University

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801