Giant T inversion and NSVT

Giant T inversion and NSVT Giant T inversion with NSVT Holter tracing showing giant T wave inversion and non sustained ventricular tachycardia, both at the beginning of the tracing and at the end. Ventricular ectopic beats are also seen in between. Variation in QRS amplitude of the NSVT beats are evident. It is likely that this will soon progress to torsades des pointes in the setting of gross QT interval prolongation. QT interval is seen as 640 ms in a cycle with cycle length of 600 ms. So, the QTc will be 640 ms. The first ventricular ectopic is followed by a good compensatory pause while the second one is almost an interpolated ventricular ectopic beat. Initial beat of the NSVT in the terminal part of the strip has a different morphology and the cycle length to the next beat is longer. It is 360 ms compared to 280 ms for the other NSVT beats. Channel 1 shows ST segment depression in the sinus beats. Giant T inversion with polymorphic NSVT Another Holter strip showing NSVT, giant T inversion and QTc prolongation. Here the polymorphic nature of the NSVT is more evident, though it is yet to evolve into the typical torsades des pointes. Isolated VPCs are also seen. The VPC at the beginning of the tracing is not followed by a compensatory pause. The PR interval of the next beat is prolonged, suggesting concealed retrograde conduction of the VPC in the atrioventricular junction. The next sinus beat also has a shorter QTc and less deep T inversion, possibly due to the shorter pr...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: ECG / Electrophysiology ECG Library Source Type: blogs