R-on-T VEB: Ventricular Fibrillation
Report:
Sinus rhythm 92/min (top)
R-on-T VEB
Ventricular fibrillation
DC defibrillation (third strip)
Post-countershock sinus bradycardia, VEB
Sinus tachycardia 115/min (bottom)
Comment:
A reperfusion arrhythmia is not expected a day after. At any rate, arrhythmias are not as good a marker of reperfusion as the diminution of the ST segment elevation. Also, AIVR rather than VF is typical of reperfusion.
The R-on-T ectopic triggers what some authorities would call ventricular tachycardia; it then (after 5 beats) âdegeneratesâ into VF. Definitional problems like this have always been with us. I prefer to call the entire run VF ab initio.
216. 58 year old man in Casualty, distressed but unable to describe it.
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