NSVT – Salvo of Ventricular Premature Complexes

NSVT – salvo of ventricular premature complexes

Leads V1- V3 show a single wide QRS complex with an M shaped pattern in V1 suggesting an origin from the left ventricle. Transition of the QRS complex of the ventricular premature complex from positive to negative occurs early, in lead V2. Leads V3-V6 have not captured any VPC. There is a salvo of three wide QRS complexes in aVR, aVL and aVF. The original meaning of the word salvo is a series of shots fired in rapid sequence from a gun or simultaneously from multiple guns. Here the wide QRS complexes occur at a rapid rate nearing 150 per minute. No wide QRS complexes are seen in leads I and III. Lead II shows wide QRS salvo in the rhythm strip. The axis of the wide QRS salvo is superior, as they are negative in leads II and aVF. This would suggest a focus in the lower part of the ventricle with activation spreading upwards.