Dressler Beats in VT
Report:
Ventricular tachycardia 160/min
Spontaneous termination
Ventricular fusion beats
Sinus tachycardia 120/min
Comment:
The fusion beat during a run of VT is known as Dressler beat12.
Note how it is easier to spot fusion beats looking at their repolarisation. The 9th complex has much shallower T wave than its neighbours; its R wave is also more slender. It is also seen in the third beat. The last VT complex, terminating the paroxysm, has most supraventricular contribution.
Fusion beats are nearest it comes to proof of ventricular ectopic origin of the broad complexes. On a later occasion, the patient demonstrated another proof, (Fig 44a), just before the cardioversion. Retrograde blocks in VT are not rare, but are rarely caught (or recognised) on ECGs. A junctional focus would be most unlikely to have a retrograde 2:1 block5.
Speaking of proofs, I recall Schamroth saying, in the unreferenced mists of time, how a pedant can never diagnose ventricular tachycardia!
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