Literature Review: pearls and pitfalls in the ECG diagnosis for ventricular tachycardia

Emergency Cardiology Literature Review & Updates with Dr. Amal Mattu


A 45-year-old with no known past medical history presents to the ED with palpitations. She is hemodynamically stable. The following ECG is obtained:

Before watching the video, look closely at this ECG and ask yourself these questions:

  1. What is your differential for regular wide complex tachycardias?
  2. Do you suspect this is VT or SVT with aberrant conduction (RBBB)?
  3. Are there any reliable ECG features that may help rule out VT?
  4. The patient is treated with adenosine which does not convert the rhythm, what would you do next?