Wide Complex Tachycardia, 12 Lead ECG and Rhythm Strip
This is a good example of wide complex tachycardia that must be evaluated for V Tach vs supraventricular rhythm with left BBB.
The rhythm initially looks regular, but becomes irregular in V1 - V3. No P waves are seen prior to the QRSs, even when the rate slows down. The typical pattern for left bundle branch block exists: wide QRS, negative QRS in V1 and positive QRS in Lead I and V6. The irregularity suggests atrial fibrillation. A longer rhythm strip would be very helpful here. The axis, which is extreme left, could be from V Tach OR left BBB. There is no precordial concordance, favoring LBBB.
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