Sudden Death During Holter Monitoring
Report:
Top:
Sinus rhythm
Dimorphic VEB couplet
Middle:
Deepening T wave inversion
VEB
R-on-T VEB following post-ectopic pause
Ventricular tachycardia 187/min following R-on-T VEB
Bottom (after carotid sinus massage):
Ventricular tachycardia 212/min
Comment:
This unfortunate manâs 12-lead ECG in VT and in sinus rhythm are shown on the next page (Fig 203a, 203b). The north-west axis, RV1 and QSV6 are diagnostic of VT - there was no need to perform the fatal massage!
The R-on-T phenomenon is, obviously, propitiated by the long preceding cycle created by the VEB139. 203a.
203b.
204. Unconscious 63 year old woman defibrillated in Casualty. Or was she?
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