Repetitive multiform narrow complex tachycardia

A 73-year-old man presented to the emergency department with palpitations. After experiencing transient exertional palpitations and dyspnea a few months earlier, investigation revealed moderate left ventricular dysfunction and extensive coronary artery disease with evidence of prior inferior infarction. He underwent bypass grafting and remained symptom free with normalization of his ejection fraction until the current presentation. Figure  1 demonstrates his presenting rhythm that did not respond to adenosine but terminated with intravenous diltiazem.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: Scheinman/Peter ECG Corner Source Type: research