This ECG is from a man who was experiencing palpitations and light-headedness with near-syncope. On first look, you will see a wide-complex tachycardia (WTC) with a rate around 240 per minute. It is difficult to assess for the presence of P waves because of the rate and the baseline artifact.
This wide complex tachycardia occurred in a 91 year old man with a history of atrial fibrillation. He complained of "fluttering" in his chest, and denied chest pain or other problems. While the paramedic attempted to start an I.V., he spontaneously converted to atrial fibrillation with left BBB, and PVCs. Once he converted, his symptoms abated. Remember, all wide complex tachycardias (WCT) should be treated as V Tach in the field, as this is by far the most common WTC and the most dangerous.
Some of the ECG clues that this WTC is ventricular tachycardia are:
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