HPI: A 50-year-old male is brought into the ED with palpitations and is found to have a regular wide complex tachycardia. He is treated with synchronized electrical cardioversion and immediately goes into ventricular fibrillation. The initial ECG and rhythm strip during cardioversion is shown below:
Case ECG
Before watching the video, look closely at this ECG and ask yourself:
- What is the most likely rhythm diagnosis based on the 12-lead ECG?
- What is the most likely reason for deterioration into ventricular fibrillation after cardioversion?
- What would be your next step in management?