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Past medical history includes coronary stenting 17 years prior. I find AV dissociation in VT to be very difficult to differentiate from artifact, as there are always random blips on tachycardia tracings. If you don't know what the dysrhythmia is, then try procainamide. Initial ED ECG: What do you think? What to do now?
This was stented. See here for management of Polymorphic Ventricular Tachycardia , which includes Torsades. Could the dysrhythmias have been prevented? Severe hypokalemia in the setting of STEMI or dysrhythmias is life-threatening and needs very rapid treatment. After pacing, there was no recurrence of Torsades.
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