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ORIGINAL RESEARCH article
Front. Vet. Sci.
Sec. Comparative and Clinical Medicine
Volume 12 - 2025 | doi: 10.3389/fvets.2025.1579951
Configuration of QRS complexes in 12-lead electrocardiogram in dogs with monomorphic ventricular tachycardias or complete bundle branch block
Provisionally accepted- 1Clinica Veterinaria Malpensa, Varese, Italy
- 2Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
- 3Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States
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The differentiation between ventricular tachycardias (VT) and supraventricular tachycardias (SVT) with bundle branch block (BBB) is clinically challenging. The aim of the study was to define by the 12-lead-electrocardiogram the QRS complex morphology in monomorphic VT (MVT) and in BBB. Twelve-lead-electrocardiograms were blindly retrospectively analyzed and categorized in four groups: sinus rhythm with left bundle branch block (SR-LBBB), sinus rhythm with right bundle branch block (SR-RBBB), MVT with RBBB configuration (MVT-RBBB), MVT with LBBB configuration (MVT-LBBB). Measurements were not normally distributed, and they were normalized by Box-Cox transformation. Repeated-measures linear mixed-effects models were constructed according to the 3 measurements performed. A total of 103 12-lead-electrocardiograms were retrospectively analyzed: 18 SR-RBBB, 18 SR-LBBB, 33 MVT-RBBB, 34 MVT-LBBB. Limb leads concordance was found in 100% of SR-RBBB, 100% of SR-LBBB, 54.5% of MVT-RBBB, 70.6% of MVT-LBBB. Precordial leads discordance was present in 100% of SR-RBBB, 100% of SR-LBBB, 78.8% of MVT-RBBB, 88.2% of MVT-LBBB. The transition point was located at V1-V2 in 100% of SR-RBBB, 100% of SR-LBBB, 50.5% of MVT-RBBB and 71.5% of MVT-LBBB. Positive V1 with M shape morphology was detected in 100% of SR-RBBB and 12% of MVT-RBBB. The mean electrical axis on the frontal plane was -108.15° (-118.29 / -101.52) in ) in RSSR -LBBB, -93.46° (-102.75/-78.49) in ) in MVT-LBBB. In case of inability to identify signs of atrioventricular dissociation, the presence of standard limb leads discordance, precordial leads concordance or discordance with transition point other than V1-V2, left limb leads and left precordial leads discordance, aVR and V1 discordance and absence of M shape configuration of the QRS complex in lead V1 is likely to be MVT. Keywords: wide QRS complex, ventricular tachycardia, bundle branch block, 12-leads electrocardiogram.
Keywords: Wide QRS complex, ventricular tachycardia, Bundle branch block, 12-leads electrocardiogram, Atrioventricular dissociation
Received: 19 Feb 2025; Accepted: 09 Apr 2025.
Copyright: © 2025 Perego, Maffei, Cavallini and Santilli. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Manuela Perego, Clinica Veterinaria Malpensa, Varese, Italy
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