Ventricular tachycardia electrocardiogram

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EKG Findings

Ventricular tachycardia in Lead II (rhythm)
  1. Abnormal and wide QRS complexes with secondary ST segment and T wave changes.
    • Usual QRS duration is > 0.12 seconds, may be shorter if the ectopic focus is located in the ventricular septum.
    • The secondary ST segment and T wave changes are in a direction that is opposite the major deflection of the QRS.
    • A ventricular rate between 140 and 200 BPM.
    • When the rate is >200 and has a sine wave appearance, it is called ventricular flutter.
    • When the rate is <110 BPM it is called non-paroxysmal VT.
  2. A regular or slightly irregular (up to 0.03 seconds) rhythm.
  3. Abrupt onset and termination.
  4. AV dissociation.
    • Atrial rate slower than ventricular rate.
    • No relationship between atrial activity and ventricular activity.
    • There can be VA conduction.
      1. The RP interval is >0.11 seconds.
      2. Occurs in about 50% of cases.
      3. Uncommon when the ventricular rate is rapid (only 1/7 when the rate was>200).
  5. Capture beats.
    • Occurs when a supraventricular impulse is conducted and captures the ventricle.
    • They are rare.
  6. Fusion beats.

Examples of Ventricular Tachycardia:





Differential Diagnosis of Underlying Causes of Ventricular Tachycardia

References

  1. Chou's Electrocardiography in Clinical Practice Third Edition, pp. 398-409.
  2. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:194 ISBN 1591032016
  3. Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5

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