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A Four-Beat Run of VT
This strip begins in sinus rhythm, then a brief run of
ventricular tachycardia occurs. Notice that the
rate changes from about 63 to a rate that varies, but is much faster.
The QRS complex widens, changing from 0.06 to 0.15, and the change in shape
is obvious. The QRS axis changes markedly in some leads.
These beats are indeed ventricular.
The run is self-limiting, there is a pause, and a ventricular escape
beat occurs. Sinus rhythm resumes. Notice that there are abnormalities
in the sinus beats. There is a pronounced Q-wave and an ST
segment elevation in lead III, an ST segment depression in lead I,
and the T-waves are inverted in leads II and III. All these abnormalities
point to an evolving inferior MI.