Ventricular Tachycardia : Useless Rabbit Ears
Report:
Ventricular tachycardia 152/min
Comment:
The diagnosis is based on the monophasic R waves in V1 and the bizarre, indeterminate, no-man’s land or north-west axis; it is supported by the QRS duration of 0.18”. It is further strengthened by the patient’s history of myocardial infarction and the pre-existing atrial fibrillation (Fig 101a).
The rabbit ears in V1 (MCL1 would be better) do not help here: a right one taller than the left is associated with 50% likelihood of ether aberrancy of ventricular ectopy.
The infarction is still diagnosable in the QR complexes in lead 3 during the VT (QS morphology of 2 and aVF does not have the same diagnostic value as a QR one).
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