Scenario: A 64-year-old male is in the holding room of the adult cardiac catheterization laboratory following primary percutaneous coronary intervention (PCI) for treatment of acute ST elevation myocardial infarction (MI). The procedure went well; however, while he was awaiting transfer to the coronary care unit, this rhythm occurs. The patient’s blood pressure is stable (110/70), he has no complaints of chest pain, and he is alert and oriented.

For every ECG, we recommend you systematically examine the following 8 features (check all that apply):

Interpretation: Ventricular tachycardia versus accelerated idioventricular rhythm (AIVR).

Ventricular tachycardia (VT) is an arrhythmia originating from an ectopic focus within the ventricular myocardium. In the above example, the rhythm is monomorphic because it is regular and originating from a single focus resulting in identical QRS complexes. No absolute ECG criteria exist for establishing the presence of VT. However, several ECG features suggest VT, including the following:...

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