ventricular tachycardia

Wide complex tachycardia (>100/min) with regular rate n single QRS morphology

Based on duration of series repititive ventr. beats
# sustained VT >30 sec duration
# nonsustained VT <30 sec

Causes
 underlying heart disease

clinical features
@ asymptomatic or haemodyanamically unstable or palpitations

ECG
@ width of QRS complex generally > 0.16 sec
@ +ve or -ve concordance of QRS complex across precordial leads
@ monophasic Rr' pattern in lead V1 (rabbit ears) with taller lft eas
@ indeterminate axis ( betn -90deg to -180deg )
@in severe underlying disease variable QRS morphology - polymorphic VT

Rx
@ In hemodynamicaly unstable pts immediate cardioversion
@ in stable pts
- amiodarone 150 mg IV over 10 min followed by 1 mg/min for 6hr n den 0.5 mg/min for nxt 18hr
- lidocaine 1- 1.5 mg/kg IV over 1 min followed by infusion at 10-40 micro gm/kg/m