Example 26

This patient presented with a broad complex tachycardia, shown in figure 1.

Figure 1

The figure shows a broad complex tachycardia 160/min with RBBB configuration and extreme heart axis. Following the broad complex tachycardia flowchart:

• Fusion beats: no
• Absence of precordial RS: no
• R-to-S > 100ms: no
• AV-dissociation: yes

Heart axis and AV-dissociation make a ventricular tachycardia most likely.

• 7.5 mg verapamil was administered, which slowed down the VT and ultimately the patient converted to sinusrhythm

Slowdown of VT after verapamil administration, now AV dissociation is more evident

After conversion to sinus rhythm