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Can You help me to interpret this ecg

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"ventricular tachycardia" AND electrocardiography

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wide complex tachycardia ventricular tachycardia guideline ECG emergency 2025

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https://www.ahajournals.org/doi/10.1161/CIR.0000000000001376

This ECG is abnormal and needs urgent clinical review.

What it appears to show

  • Regular broad-complex tachycardia, about 120 beats/min
  • Very wide QRS: printed measurement about 172 ms
  • Pattern consistent with right bundle branch block plus left anterior fascicular block, also called a bifascicular block
  • The machine has labelled it “ventricular tachycardia,” but that automated interpretation is not confirmed and must not be relied on by itself.
  • The key concern is distinguishing:
    1. Ventricular tachycardia (VT), a potentially dangerous ventricular rhythm, from
    2. A supraventricular rhythm, such as sinus or atrial tachycardia, conducted through pre-existing bundle-branch/fascicular block.
Because it is a regular wide-complex rhythm, it should be treated as possible VT until a qualified clinician reviews the tracing and the patient. Wide-complex tachycardia can result from VT, bundle-branch block, pre-excitation, pacing, or occasionally electrolyte/drug problems. AHA adult life-support guidance and Tintinalli’s Emergency Medicine advise considering VT in this setting (p. 156).

What to do now

Go to the emergency department now or call emergency services if this ECG is current, particularly if there is:
  • chest pain or pressure
  • fainting, near-fainting, confusion, marked dizziness
  • shortness of breath
  • sweating, pallor, weakness
  • low blood pressure
  • persistent palpitations
If the person is unconscious, collapsing, or has no normal breathing, call emergency services immediately and begin CPR if trained.
Even if feeling well, this should be assessed today, with a repeat ECG/rhythm strip, vital signs, electrolytes including potassium and magnesium, medication review, and cardiac evaluation. A clinician may compare it with an old ECG to determine whether the conduction block is new. In an unstable patient with wide-complex tachycardia, immediate synchronized cardioversion is recommended. AHA guidance
Please do not take anti-arrhythmia medicines or attempt vagal maneuvers based only on this photo.
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