Wide Complex Tachycardias: using modified ECG leads to distinguish ventricular tachycardia from supraventricular tachycardias (VT vs. SVT)

ECG Weekly Workout with Dr. Amal Mattu


A 60-year-old man presents to the emergency department with left sided chest pain and lower extremity edema. Initial vitals: HR= 155, BP = 120/96, RR = 22, SpO2 = 90%, afebrile. The following ECG is obtained:

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

  1. What is the heart rate and underlying rhythm?
  2. What type of modified ECG leads can be used to help better detect atrial activity?