WIDE-QRS TACHYCARDIAS INTRODUCTION

No P waves are seen in this wide-wide tachycardia. The overall morphology is “like” LBBB. This is an example of V.T. demonstrating “Josephson’s criteria”. Dr. Mark Josephson identified distinctive features in patient’s with wide-QRS tachycardia “resembling LBBB”. There are three features in V1 that allow a judgement. They are shown above and are present in is this tracing. A = “fat” initial R wave >.03 sec. B = “slurred and notched” downslope C = the nadir of the S wave is far removed from the onset of the QRS complex. Dx: ventricular tachycardia.