{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T06:58:26Z","timestamp":1785394706868,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[1996,12]]},"abstract":"<jats:p>OBJECTIVE: To determine the features that distinguish bundle branch reentry (BBR) ventricular tachycardia from a supraventricular tachycardia with aberration on the 12 lead electrocardiogram (ECG). PATIENTS: Three patients in whom premature beats (2 cases) or sustained tachycardia (2 cases) showed a QRS configuration identical to that observed during sinus rhythm. INTERVENTIONS: Programmed electrical stimulation. RESULTS: These arrhythmias were ventricular in origin and caused by a BBR mechanism, as suggested by the following data obtained during electrophysiological study: (a) an H-V interval shorter during tachycardia than during sinus rhythm; (b) A-V dissociation; (c) activation of the right bundle branch before activation of the bundle of His. The ECG of all 3 patients showed right bundle branch block with very prolonged QRS duration (0.16 to 0.20 s). Characteristically, all 3 had prolonged H-V interval during sinus rhythm. All patients had had a previous myocardial infarction and had a dilated left ventricle. CONCLUSION: The presence of (a) wide complex extrasystoles or tachycardia with a QRS morphology identical to that of sinus rhythm; (b) A-V dissociation; and (c) a very prolonged QRS duration (0.16 s or more) is suggestive of ventricular tachycardia caused by bundle branch reentry.<\/jats:p>","DOI":"10.1136\/hrt.76.6.541","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:46:00Z","timestamp":1190137560000},"page":"541-547","source":"Crossref","is-referenced-by-count":17,"title":["Wide complex tachycardia with atrioventricular dissociation and QRS morphology identical to that of sinus rhythm: a manifestation of bundle branch reentry."],"prefix":"10.1136","volume":"76","author":[{"given":"G.","family":"Oreto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. L.","family":"Smeets","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. M.","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Timmermans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. J.","family":"Wellens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1996,12,1]]},"reference":[{"key":"ref_1","article-title":"The ECG in emergency decision making","author":"Wellens, H.J.J.; Conover, M.B.","year":"1992","unstructured":"Wellens HJJ, Conover MB. The ECG in emergency decision making. 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Bundle branch reentrant ventricular tachycardia. Cumulative experience in 48 patients. Cardiovasc Electrophysiol 1993;4:253-62.","journal-title":"Cardiovasc Electrophysiol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1161\/01.CIR.82.5.1561","article-title":"The clinical spectrum of ventricular tachycardia","volume":"82","author":"Akhtar, M.","year":"1990","unstructured":"Akhtar M. The clinical spectrum of ventricular tachycardia. Circulation 1990;82: 1561-73.","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1016\/0735-1097(93)90602-W","article-title":"Bundle branch reentry: a mechanism of ventricular tachycardia in the absence of myocardial or valvular dysfunction","volume":"22","author":"Blanck, Z.; Jazayeri, M.; Dhala, A.; Deshpande, S.; Sra, J.; Akhtar, M.","year":"1993","unstructured":"Blanck Z, Jazayeri M, Dhala A, Deshpande S, Sra J, Akhtar M. Bundle branch reentry: a mechanism of ventricular tachycardia in the absence of myocardial or valvular dysfunction. JAm Coll Cardiol 1993;22:1718-22.","journal-title":"JAm Coll Cardiol"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1111\/j.1540-8167.1995.tb00421.x","article-title":"Cure of interfascicular reentrant ventricular tachycardia by ablation of the anterior fascicle of the left bundle branch","volume":"6","author":"Crijns, H.J.G.M.; Smeets, J.L.R.M.; Rodriguez, L.M.; Meijer, A.; Welens, H.J.J.","year":"1995","unstructured":"Crijns HJGM, Smeets JLRM, Rodriguez LM, Meijer A, Welens HJJ. Cure of interfascicular reentrant ventricular tachycardia by ablation of the anterior fascicle of the left bundle branch. Cardiovasc Electrophysiol 1995;6: 486-92.","journal-title":"Cardiovasc Electrophysiol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/0022-0736(88)90115-X","article-title":"Ventricular tachycardia masquerading as supraventricular tachycardia: a wolf in sheep's clothing","volume":"21","author":"Olshansky, B.","year":"1988","unstructured":"Olshansky B. Ventricular tachycardia masquerading as supraventricular tachycardia: a wolf in sheep's clothing. Electrocardiol 1988;21:377-84.","journal-title":"Electrocardiol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/0002-9149(87)90857-5","article-title":"Hazards of intravenous verapamil for sustained ventricular tachycardia","volume":"59","author":"Buxton, A.E.; Marchlinski, F.E.; Doherty, J.U.; Flores, B.; Josephson, M.E.","year":"1987","unstructured":"Buxton AE, Marchlinski FE, Doherty JU, Flores B, Josephson ME. 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Circulation 1988;78:246-57.","journal-title":"Circulation"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.76.6.541","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T13:29:17Z","timestamp":1758374957000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.76.6.541"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1996,12]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1996,12,1]]},"published-print":{"date-parts":[[1996,12]]}},"alternative-id":["10.1136\/hrt.76.6.541"],"URL":"https:\/\/doi.org\/10.1136\/hrt.76.6.541","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[1996,12]]}}}