The ECG shows a narrow complex tachycardia at 190 beats/min with ST-segment depressions in V3 V5.
(2) A negative/positive P wave in leads V1 or V2 and relatively narrow P waves on surface ECG are highly predictive of AT arising from the atrial septum, however, it provides little help for differentiating AT origin from the RAS, NCC, and AMJ/LC C
ECG QRS duration narrowed to 96 ms. However, despite 8 mg metaraminol delivered in 2-mg increments, the blood pressure deteriorated to 70/58 mmHg (pulse rate 130 beats per minute; Figure 2) at time 115 min. Given the ongoing haemodynamic instability, a decision was made to undertake lipid rescue treatment while preparations were made for central line insertion and anticipated vasopressor infusion.
At 115 min after drug ingestion, 100 ml 20% lipid emulsion (Intralipid®, Fresenius Kabi) was injected over 1 min followed by a further 400 ml over 30 min. Following administration ECG QRS duration narrowed further to 80 ms, the heart rate was 120 beats per minute, and BP 140/80 mmHg.
Interestingly, in the remaining 6 patients, recurrent VT exhibited a different ECG morphology, with narrower QRS and variable inferior axis.
Dr C Getting back to the ECG, the patient has a narrow complex tachycardia with a rate of 190 beats/min with 2 3 mm ST-segment depressions across the precordium.
Her ECG showed a complete heart block with narrow QRS complex, indicating a high nodal impulse with a rate of 50/min.
As shown in Figure 3, electrical noise appears as a narrow band at 50 Hz, whereas electro-oculogram and ECG artifacts are limited at low frequency areas, instead of widespread EMG activity.
However, there are no suggestive changes on the ECG, and the heart size looks normal, somewhat narrow, and probably under-filled, which is consistent with hypovolemia.
Both children showed an electrocardiogram (ECG) with a markedly short repolarization time and conspicuously narrow and peaked T waves (QTc interval, 331 ms) (Fig. 1B).
