STAT ECG Diagnoses: ventricular arrhythmias in patient with left ventricular assist devices (LVADs)

ECG Weekly Workout with Dr. Amal Mattu


A 42-year-old male with PMHx of ischemic cardiomyopathy is brought in by ambulance reporting that his defibrillator has shocked him five times today. He is asymptomatic and texting on his cell phone on arrival. The following ECG is obtained:

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

  1. What is the rhythm?
  2. What is the most likely cause of the peculiar appearance of leads V5 & V6?
  3. What is the best first line treatment for this rhythm?