Etiology:

• Coronary heart disease with status post infarct

Mechanism:

• Area in the region of the infarction scar with delayed impulse conduction facilitates a reentry circuit

ECG characteristics:

• Tachycardia with wide QRS complex

Acute treatment:

• Defibrillation
  
• If hemodynamically stable, also attempt termination with antiarrhythmics (class IB, amiodarone) in intensive care

Chronic treatment:

• In the majority of cases implantation of a defibrillator (ICD)
  
• Antiarrhythmics and ablation treatment rarely curative, more frequently used as adjuvant treatment to reduce the frequency of arrhythmic episodes

Idiopathic ventricular tachycardia arising from the right ventricular outflow tract (RVOT)

Mechanism:

• Triggered activity or abnormal automation

ECG characteristics:

• Tachycardia with wide QRS complex
  
• Inferior axis (ranging from right to marked right axis deviation); left bundle branch configuration
  
• V1: “QS” configuration (absent “r“)
  
• Tall narrow “R” in leads II and III
  
• Small “R” or “rS” in lead I

Repetitive monomorphic right ventricular tachycardia (GALLAVERDIN)

Mechanism:

• Triggered activity

ECG characteristics:

• Tachycardia with wide QRS complex
  
• Left bundle branch configuration
  
• Inferior axis (right to marked right deviation)