Scenario: This electrocardiogram (ECG) rhythm strip (leads II and V1) is from a 56-year-old African American man, 11 hours after admission to the coronary care unit (CCU) with chest pain and a non–ST-elevation myocardial infarction (NSTEMI) per cardiac troponin levels (> 0.10 ng/mL); this is his first MI. He was treated with primary percutaneous coronary intervention (PCI), during which a stent was placed in the circumflex coronary artery. While reviewing the alarm history at the central monitor, his CCU nurse found this rhythm strip and wonders if he should notify the patient’s cardiologist.

Sinus tachycardia at 110 beats/min, with premature atrial contractions ([PAC] the letter “S” for supraventricular appears above them) and a 3-beat episode of paroxysmal supraventricular tachycardia (PSVT). It is important to differentiate ventricular tachycardia (VT) from SVT because the later responds well to an atrioventricular (AV) node blocking agent, but the same drug can compromise...

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