When to Default to VT and When to Doubt It

ECG Weekly Workout with Dr. Amal Mattu

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HPI

A 64-year-old man presents to the emergency department with palpitations. He was recently found to have an acute MI and is one day s/p RCA stenting. The following ECG is obtained:

Before watching this week’s workout, carefully review the ECG and consider the following:

1. 1. What is your differential for this wide complex tachycardia?
   2. What heart rate range is typical of ventricular tachycardia (VT)?
   3. Are there any ECG findings that favor VT over SVT?
   4. Would you manage this rhythm as VT, SVT with aberrancy, or something else?