Rhythm & Rate 5

Describe the ECG changes and the rhythm in Case R_0005

Figure_1

Figure_1

Figure_2.  MagnifiedpartofR_0005

Figure_2.  MagnifiedpartofR_0005

A broad complex tachycardia is present, with a regular rhythm and a rate of about 214 beats per minute. P waves are not clearly visible, although an occasional small hump (red asterick) might be due to a P wave. The complexes have a sine wave pattern, although small notches (blue arrows) are seen on the downstroke of some of the complexes. Subtle electrical alternans is present (best seen in the lower strip). Capture beats and fusion beats are not seen.

The following terms could be applied to the above rhythm: a broad complex tachycardia (BCT), monomorphic ventricular tachycardia or ventricular flutter