ECG 129

ECG 129 A 60-year-old man had complained of occasional episodes of palpitations for several years. Between attacks he was well, there were no physical abnormalities, and his ECG was normal. Eventually this ECG was recorded during one of his attacks. What is the arrhythmia and what would you do?

Answer 129

The lead II rhythm strip at the bottom of the record shows that the rhythm changes half way through the recording, and this makes interpretation difficult. However, the ECG shows:

• Regular broad complex tachycardia, rate 160/min, followed by sinus rhythm, rate 120/min

• Normal axis during the tachycardia

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