Ventricular Tachycardia in 69 year-old man


Does this Wide complex tachycardia represents Ventricular Tachycardia or Supraventricular Tachycardia with abberancy?

  • The QRS axis is normal – this could be VT or SVT
  • The QRS is wide, over 0.14s
  • The QRS complexes are upright in all the precordial leads (positive concordant pattern) – this favors VT
  • The morphology is not typical for RBBB – this would support VT
  • Absence of an RS pattern strongly favors VT
  • The most compelling point is provided in the ladder diagram bellow. There are retrograde P waves following every other QRS complex. This represents ventriculo-atrial conduction (VA association) and makes VT a virtual certainty.

So the diagnosis is Ventricular Tachycardia.