Ventricular Arrhythmia ECG 3

1. Normal sinus rhythm
2. Incomplete right bundle branch block
3. Prolonged QT interval
4. Polymorphic ventricular tachycardia (Torsades de Pointes)

There are only a few sinus rhythm QRS complexes available to examine on this ECG. Using lead V1 an incomplete right bundle branch block is seen. A prolonged QT interval is present that extends all the way to the next P wave (best seen in lead V5). The unusual wide QRS complex, tachycardic rhythm that changes morphology and axis within a few beats (see V1 rhythm strip at that bottom) is characteristic of polymorphic (meaning many shapes) ventricular tachycardia. This is also known as Torsades de Pointes which translates in French to "twisting of the spikes." A different example is below:

Related Topic Reviews: Prolonged QT, Ventricular Tachycardia, Right Bundle Branch Block