Wide Complex Tachycardias: precordial concordance and what to do when some leads appear narrow and others appear wide

ECG Weekly Workout with Dr. Amal Mattu


A 38-year-old man is brought to the emergency department by EMS for palpitations after he is found to be tachycardic. He is noted to be hypotensive with SBP of 70 while the following ECG was obtained:

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

  1. What is the heart rate and rhythm?
  2. Are the QRS complexes narrow or wide?