Sustained Multiform Ventricular Tachycardia

Report:

Top three strips:

Multiform ventricular tachycardia, sustained, 240 – 260/min

Fourth strip: (post-DC cardioversion)

Accelerated idioventricular rhythm 70 – 72/min

Bottom strip:

Sinus rhythm

Comment:

Considering the type of customer that comes to ICU post-AAA repair, cardiac events are surprisingly rare; most of those are runs of AF. This patient was something of an exception.

Multiform VT often has long uniform stretches; the morphology of the VT does not appear to have any specific therapeutic implications. The rate does: the faster the VT, the more likely is hæmodynamic collapse or “degeneration” into VF. This one, as usual, resisted xylocaine and required 200 Joule cardioversion.

The sinus rhythm ECG, showing LAA and old inferior MI, is shown below (Fig 192a).

192a.

193. Post-arrest monitoring of a 74 year old woman with large anterior MI.

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