Wide Complex Rhythms

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    72 year old female with palpitations.

    72 year old female with palpitations.

    Key Findings

    - Ventricular Tachycardia

    Coding for the Boards

    - Ventricular Tachycardia

    - Ventricular pacer normally functioning

    Answers

    Discussion: Morphology using the aVr algorithm clearly reveal this to be VT. There is a biventricular pacer that is intermittently executing a atrioœventricular sense response when the VT falls within the tracking rate of the device. This is best seen in V5, V6. This is normal pacemaker function and underscores the deficiency of the board coding sheets for paced rhythms.