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Ventricular Tachycardia example one


br>This strip begins with six beats of sinus rhythm.  Suddenly this rhythm changes to a wide-complex tachycardia, with a rate varying from 160 to 190.  It is easy to mis-diagnose ventricular tachycardia , and optimally a 12-lead EKG should be obtained.  However, this rhythm strip shows many of the hallmarks of true VT: notice the wide QRS complex (greater than 0.14 second), the irregular rate, the slurring from depolarization into repolarization, and that the repolarization phase is opposite the isoelectric line in every lead.  Also, when the rhythm change occurs, a change in QRS axis is seen in some leads, and the QRS shape in V1 is biphasic rather than triphasic (triphasic would favor right bundle branch block), with the first rabbit-ear larger than the second.