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Fariba F, Khansari N. A Case Report of Bifid T Wave due to QT Segment Prolongation in Acute Coronary Syndrome . Avicenna J Clin Med 2015; 22 (2) :161-164
URL: http://sjh.umsha.ac.ir/article-1-47-en.html

Introduction: Bifid T waves are seen in healthy young children and alcoholic adults. They also occur in certain pathological conditions, including organic heart diseases, and the central nervous system disorder. Myocardial ischemia can affect T wave morphology in a variety of ways one of which is t wave change as bifid t wave observed in QTc prolongation forms oc-curring in acute coronary events.

 Case Report: The patient, a 48 year old man, came to the emergency room because of typical chest pain starting 2 days before his visit. He had a history of ischemic heart disease. His vital signs were stable. In his ECG at emergency ward ST elevation was seen at inferior leads. At the time of his recent admission in CCU, he experienced one episode of ventricular fibrillation (VF) converted to sinus rhythm by 200j DC shock. In his first ECG after VF prolonged QTc as bifid T wave was obvious.

Conclusion: Myocardial ischemia can affect T wave morphology in a variety of ways one of which, is t wave change as bifid t wave that is one of QTc prolongation diagnostic forms oc-curring in acute coronary events and malignant arrhythmia.