AV sequential pacing https://www.ecgguru.com/taxonomy/term/157/all en AV Sequential Pacing to Ventricular Tachycardia https://www.ecgguru.com/ecg/av-sequential-pacing-ventricular-tachycardia <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/av-sequential-pacing-ventricular-tachycardia"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/WCTPM100.png" width="1800" height="709" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This is an interesting ECG for showing students AV sequential pacing and also ventricular tachycardia.&nbsp; The unusual thing about this ECG is that the V Tach starts at the time the machine begins recording the precordial leads.&nbsp; This particular ECG machine shows a slight "gap" at the lead change, so we don't see the actual start of the V Tach.&nbsp; Both rhythms have wide QRS complexes. The pacemaker is pacing the right ventricle, so you will see a wide QRS with a leftward axis, as the impulse spreads up and leftward toward the left ventricle.&nbsp;&nbsp; The V Tach portion is, of course, limited to the precordial leads, so we cannot plot the frontal plane axis.&nbsp; But, it meets many of the accepted criteria for ventricular tachycardia, including:&nbsp; very wide QRS, negative QRS in Lead V6,&nbsp;absence of RBBB or LBBB pattern.&nbsp;&nbsp; For more on recognizing V Tach in a WCT, go to&nbsp;Ask the Expert at this <a title="VT Criteria" href="http://www.ecgguru.com/content/what-are-criteria-determining-wide-complex-tachycardia-v-tach">LINK</a>.&nbsp;&nbsp;&nbsp;&nbsp;</p> <p>This is also a very good example of how the interpretation by the machine can be wrong.&nbsp; Always read the ECG yourself!</p> </div></div></div> Wed, 01 Aug 2012 17:01:04 +0000 Dawn 275 at https://www.ecgguru.com