Monomorphic vs. Polymorphic VT

Great job to those who answered our poll questions!

  1. What do you look at if called about possible NSVT and/or VT? Yes, all of the above. Look at QT duration, electrolytes (K and Mg), medications that prolong QT and low ejection fraction.
  2. The first image showed polymorphic VT, then post-cardioversion showed a normal QT –> making early ischemia or low EF much more likely – making the situation more dangerous. Please see below:

Screenshot 2016-08-19 10.21.28

ECG showing AV dissociation + capture beat + fusion beat

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AV Dissociation:  P waves appearing independently of the QRS complexes

Fusion beat: an impulse coming from above the atrioventricular node fusing with an impulse generated in the ventricle

Capture beat: reflect an impulse coming from above the atrioventricular node that depolarizes the ventricles when they are no longer refractory but before the next ventricle-generated complex