Fast Ventricular Tachycardia with Visible AV Dissociation
Report:
Ventricular tachycardia 214/min
AV dissociation
Comment:
The morphology is somewhat equivocal, V1 showing RRâ complexes with right rabbit ear taller than the left; nevertheless, they are essentially monophasic and over 0.14â, favouring ectopic origin rather than RBBB aberrancy. The LAD is non-contributory.
There is also some mappable dissociated atrial activity in the rhythm strip. Most likely it represents sinus P waves, but retrograde conduction subject to some kind of VA block cannot be excluded.
Over 12 hours the patientâs troponin rose to 75 µg/L (normal < 0.4), consistent with myocardial infarction seen in the next ECG (Fig 216a). The P waves are prominent enough (at least their PTF in V1) to be âseen throughâ the VT of the original tracing. The LAD (due to LAHB) is also present in sinus rhythm; this has no diagnostic or prognostic implications in this setting.
216a. Cautious report because there are no reciprocal changes. There are of course other reasons for this.
217. 61 year old man with recent basal infarction.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.