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Challenges in Clinical Electrocardiography |

Wide Complex Tachycardia Recorded With a Smartphone Cardiac Rhythm Monitor

Jonathan W. Waks, MD1,2; Adam S. Fein, MD1,2; Saumya Das, MD, PhD1,2
[+] Author Affiliations
1Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
2Department of Cardiovascular Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2015;175(3):437-439. doi:10.1001/jamainternmed.2014.7586.
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An active 62-year-old man with no medical problems began to experience frequent, sudden episodes of exertional near-syncope and syncope. The episodes were not associated with any prodromal symptoms. A neurologic evaluation was unrevealing. A transthoracic echocardiogram demonstrated a structurally normal heart, and the patient’s resting electrocardiogram (ECG) was normal. On advice from his primary care physician, the patient purchased an AliveCor cardiac monitor (AliveCor) to allow recording and transmission of cardiac rhythms through his smartphone.1 During an episode of near-syncope, the patient recorded runs of wide complex tachycardia lasting up to 6 seconds (Figure 1).

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Figure 1.
Rhythm Strip Recorded by the AliveCor Monitor During an Episode of Presyncope
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Figure 2.
Right Ventricular Outflow Tract Tachycardia

Right ventricular outflow tract tachycardia induced during electrophysiology study that reproduced the patient’s symptoms.

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Figure 3.
Photographs of the AliveCor Cardiac Monitor

A, AliveCor cardiac monitor interface. B, Two to three fingers from each hand are placed on each electrode to record a cardiac rhythm strip lasting up to 30 seconds. Reproduced with permission from Saxon.1

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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