title: [Wide QRS tachycardia preceded by pacemaker spikes].
abstract: The differential diagnosis and therapeutic management of wide QRS tachycardia preceded by pacemaker spike is presented. The pacemaker-mediated tachycardia, tachycardia fibrillo-flutter in patients with pacemakers, and runaway pacemakers, have a similar surface electrocardiogram, but respond to different therapeutic measures. The tachycardia response to the application of a magnet over the pacemaker could help in the differential diagnosis, and in some cases will be therapeutic, as in the case of a tachycardia-mediated pacemaker. Although these conditions are diagnosed and treated in hospitals with catheterization laboratories using the application programmer over the pacemaker, patients presenting in primary care clinic and emergency forced us to make a diagnosis and treat the haemodynamically unstable patient prior to referral.
authors.affiliation: Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España. Electronic address: manuel.romero.gonzalez.sspa@juntadeandalucia.es.
authors.forename: M
authors.initials: M
authors.lastname: Romero
authors.affiliation: Servicio de Cardiología, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
authors.forename: A
authors.initials: A
authors.lastname: Aranda
authors.affiliation: Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Gómez
authors.affiliation: Servicio de Urgencias, Hospital de Alta Resolución de Écija, Écija, Sevilla, España.
authors.forename: A
authors.initials: A
authors.lastname: Jurado
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004868:Equipment Failure; D005260:Female; D006801:Humans; D008280:Magnetics; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D013610:Tachycardia / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
keywords: Atrial fibrilation and pacemaker; Marcapasos malfuncionante o desbocado; Marcapasos y fibrilo-flutter auricular; Pacemaker-mediated tachycardia; Runaway pacemaker; Taquicardia mediada por marcapasos