Journal 2

The ECG role in identifying the

etiology of Tachycardia-Induced
Cardiomyopathy
Introduction
Tachycardia-induced cardiomyopathy is a well
recognised entity of heart failure and various
mechanisms due to tachyarrhythmias have been
postulated to be responsible for impaired cardiac
contractility.
A 16 years old who has been diagnosed to have TIC
by using 12 led ECG, which was misinterpreted
initially as sinus tachycardiase.

 A 16 years old who has been diagnosed to have TIC by

using 12 led ECG, which was misinterpreted initially as
sinus tachycardiase.
The standard 12-lead electrocardiogram is a
representation of the heart's electrical activity recorded
from electrodes on the body surface.
It can measure the overall magnitude of the heart's
electrical potential from twelve different angles ("leads")
and is recorded over a period of time (usually 10
seconds).
Objective
The objective is the importance of a 12-lead
electrocardiogram in detecting the tachycardia- induced
cardiomyopathy.

Case
A 16 years old boy, with a six-month
history of congestive heart failure was
quite symptomatic and had a
significant history of shortness of
breath at rest.
An electrocardiogram showed nonsinus tachycardia with rate of 160
beats/min and inverted P-wave was
noted at lead I, aVL and the upright Pwaves at the inferior leads.

Non-sinus
tachycardiase

Sinus
tachycardiase

Discussion
Several studies have been published and
focused on 12-lead analysis of p-wave
morphology to determine the origin of
tachycardia.
Leads aVL and V1 are the most useful to
distinguish between right and left origin.
In the patient a firm diagnosis of the left atrial
tachycardia was made on the basis of a standard
12 lead ECG finding, which reveals a single
abnormal P-wave axis and inappropriate heart
rate for the patients age, which was out of
proportion of compensatory heart failure
mechanism.

Conclusion
A standard 12-lead surface ECG provides a
simple and non-invasive method that can
help in determine of the origin of
tachycardia.