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Monomorphic ventricular tachycardia on an ECG strip

Regular, wide and over 100/min, with every complex the same shape.

What to look for

A regular, wide-complex tachycardia over 100/min, with every complex the same shape. The atria are dissociated, but you'll see their P waves, capture beats and fusion beats in only a minority of cases. Not finding them doesn't rule it out.

Examples

Each strip is 6 seconds of lead II, drawn to scale (25 mm a second, 10 mm a millivolt), so you can count boxes the way you would on paper. Each one is a different example, measured below it.

Example 1 · lead II · 6 seconds
II25 mm/s · 10 mm/mV
Rate
183/min18 QRS complexes in 6 seconds × 10 = 180/min
Rhythm
Regular
P waves
Not visible
P to QRS
No visible P waves
PR
None to measure
QRS
0.18 s, wide
Example 2 · lead II · 6 seconds
II25 mm/s · 10 mm/mV
Rate
175/min18 QRS complexes in 6 seconds × 10 = 180/min
Rhythm
Regular
P waves
Not visible
P to QRS
No visible P waves
PR
None to measure
QRS
0.18 s, wide
Example 3 · lead II · 6 seconds
II25 mm/s · 10 mm/mV
Rate
160/min16 QRS complexes in 6 seconds × 10 = 160/min
Rhythm
Regular
P waves
Upright in II, uniform
P to QRS
None: dissociated P waves
PR
None to measure
QRS
0.12 s, wide

Don't confuse it with

Want a new strip every time? The ECG Drill in the app draws a fresh, measured example on every try and steers you toward the rhythms you miss. It's part of the Paramedic level, and you can try 5 strips a day free.

Try the ECG Drill

Where the criteria come from

Others in the Ventricular group