Fig. 48.2 This monitoring strip shows four sinus beats initially, and then, after a pause prior to the succeeding sinus beat, a run of a very broad complex tachycardia, showing substantial axis shift from sinus rhythm, and clear-cut independent P wave activity (arrowed). Indisputably, this is ventricular tachycardia.

Fig. 48.3 Long QT interval dependent non-sustained ventricular tachycardia (NSVT). The arrowed beats (rhythm strip) are sinus. They have a very long QT interval, difficult to fully measure, as, before they fully finish, a ventricular ectopic arises or a run of 12 beats of NSVT. The sinus rhythm ECG looks diffusely abnormal (non-specific QRS broadening, T wave flattening) but it is difficult to be categorical, as not enough of the ECG is visualized. The patient had syncope, and was on psychotropic drugs; the diagnosis was long QT dependent ventricular tachycardia, induced by drugs.

Non-sustained ventricular tachycardia (NSVT) is ventricular tachycardia (VT) (i.e. ≥ 3 ventricular beats strung together with no intervening supraventricular beat) that terminates spontaneously within 30 s (Table 48.1). It is a common and important rhythm disturbance; it may give rise to no symptoms, near or actual fainting and/or palpitations. It is associated with sustained VT and sudden cardiac death. The ECG appearance of NSVT is the same as sustained VT, except that it does not last as long!

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