Wide Complex Tachycardias: what you gotta know about the two major types of polymorphic ventricular tachycardia

ECG Weekly Workout with Dr. Amal Mattu


A 66-year-old female with a history of substance abuse on methadone is brought to the ED for syncope and altered mental status. She is altered and agitated on arrival and receives haloperidol and benzodiazepines to facilitate her workup. The following ECG is obtained before the patient briefly goes into polymorphic ventricular tachycardia:

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

  1. What is your full ECG interpretation?
  2. What is the most likely cause of the patient’s deterioration to polymorphic VT?
  3. How would you work up and manage this clinical scenario?