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Abstract
The refractory period of the right bundle branch is increased when the R-R interval
between the prior two conducted impulses is long. Thus, an impulse that arrives soon
after the second of two impulses separated by a long R-R interval may be aberrantly
conducted with a right bundle branch block morphology on electrocardiogram. This aberrant
conduction is termed “Ashman's phenomenon” and is often responsible for isolated wide
QRS complexes in the presence of underlying atrial fibrillation. This process may
also produce runs of wide QRS complexes that must be distinguished from nonsustained
ventricular tachycardia. A case of such multibeat Ashman's phenomena is presented,
and the characteristics used to identify this phenomenon are discussed. A brief review
of several recent studies on the differentiation of sustained ventricular tachycardia
from supraventricular tachycardia with aberrancy in the setting of a regular underlying
rhythm is given as well.
Keywords
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References
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Article info
Publication history
Accepted:
September 17,
1991
Received in revised form:
August 27,
1991
Received:
April 16,
1991
Identification
Copyright
© 1992 Published by Elsevier Inc.