Which rhythm is Ventricular Tachycardia?

• A. Ventricular Tachycardia
• B. Atrial Fibrillation with Rapid Ventricular Response
• C. Sinus Tachycardia
• D. Torsades de Pointe

Answer: (A)

Ventricular tachycardia is a fast rhythm that starts in the ventricles rather than the atria. On telemetry, you’ll see a rapid, regular heartbeat with wide QRS complexes (usually greater than 120 ms) because the depolarization is occurring through the ventricular myocardium rather than the normal His-Purkinje system. P waves, if visible, are often not tied to the QRS complexes, and AV dissociation can occur, reflecting the ventricles driving the rhythm.

This pattern is distinct from other tachyarrhythmias: atrial fibrillation with rapid ventricular response is irregular with no organized atrial activity and typically has narrower QRS unless aberrant conduction; sinus tachycardia is a fast rate with normal P waves preceding each QRS and a normal QRS duration; torsades de pointes is a polymorphic form of VT with a characteristic twisting QRS pattern around the baseline. Because the described rhythm matches a fast, regular, wide-complex tachycardia originating in the ventricles, it is ventricular tachycardia.