Cardioversion of Ventricular Tachycardia on Monitor Rhythm Strip

Cardioversion of Ventricular Tachycardia on Monitor Rhythm Strip

Cardioversion of ventricular tachycardia
Cardioversion of ventricular tachycardia

Ventricular tachycardia is a life threatening ventricular arrhythmia which can lead to hypotension and sometimes degenerate into ventricular fibrillation if not treated promptly. The tracing above shows a fast wide QRS tachycardia, which is terminated by a DC shock, leading to restoration of sinus rhythm in the latter part of the rhythm strip. Here it is a fast ventricular tachycardia with rate of around 225 per minute which produced hemodynamic compromise and needed rapid cardioversion. If the rate is not so fast, it may be better tolerated, allowing pharmacological therapy with intravenous lignocaine or amiodarone.

Some cases of ventricular tachycardia can be terminated by overdriving pacing, especially in situations where a pacing wire is already in situ for some other reason. If there is an implanted cardioverter defibrillator, the device will automatically detect the tachycardia and try to terminate it either by overdrive pacing or shock, depending on the rate of the tachycardia and the programmed therapies. If a single shock only zone is programmed, it will terminate all tachycardias with a shock. If multiple zones of therapies are programmed, slow ventricular tachycardias could be pace terminated while fast VTs will need shocks.