What is this Regular SVT?

===================================MY Comment by KEN GRAUER, MD (11/12/2019):===================================My appreciation to Kenneth Khoo for this case. This patient was hemodynamically stable. There was debate among providers in his institution as to what the rhythm in this ECG was (Figure-1).What do YOU think the rhythm is?What is the differential diagnosis?Why can you be virtually certain what this rhythm is even before treating and before any diagnostic maneuvers?Figure-1: The initial ECG in this case (See text).My Approach to this Rhythm: I reviewed the basics for rhythm interpretation in the October 16, 2019 Case from Dr. Smith ’s ECG Blog. In brief — once you’ve assured that your patient is hemodynamically stable (as this patient was) — We need to assess the remaining 5 KEY parameters. I favor this memory aid, “Watch your Ps, Qs and the 3 Rs ”:NOTE: It does not matter in what sequence you address these 5 KEY parameters — and I often change the sequence I use depending on the tracing (ie, Which of these 5 parameters is easiest to assess in the tracing in front of you?).For the tracing in Figure-1  — the rhythm is perfectly Regular. The R-R interval is almost exactly 2 large boxes — which means that the ventricular Rate is 300/2 ~150/minute. The ...

Source: Dr. Smith's ECG Blog - November 11, 2019 Category: Cardiology Authors: ECG Interpretation Source Type: blogs