A 67-year-old male with a 15-year history of ischemic heart disease and ventricular dysrhythmias was admitted to a telemetry unit for evaluation of syncopal episodes. One afternoon, he had an abrupt onset of a wide QRS complex tachycardia at a rate of 150/min (Figure 1). The telemetry technician called out to the staff that the patient was in ventricular tachycardia and called a code blue. The nursing staff found the patient to be awake and alert, reading the newspaper with a blood pressure of 140/64 mm Hg. The code blue team arrived. On the basis of the patient’s mental status and blood pressure, the physician made the assumption that the patient was in supraventricular tachycardia (SVT). Verapamil 5 mg intravenous push was ordered and administered. The patient lost consciousness, his blood pressure dropped, then he developed ventricular fibrillation (Figure 2). He received defibrillation and was transferred...

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