This ECG is from a 17 year old female without evidence of underlying heart disease but with an eight year history of palpitations and tachycardia. Do you think this wide complex tachycardia is supraventricular with aberrant conduction or is it ventricular tachycardia?
Before going to the next page, look first for P waves, If they are present, determine whether they are associated with the QRS complexes or dissociated from them.
Look next at the duration and configuration of the QRS complex. Do they meet criteria for bundle branch or fascicular block?
Then, apply the Brugada algorithm. Are there RS complexes in any of the chest leads? and is the interval from the onset of the R wave to the nadir of the S wave greater than 100 ms in any of the V leads?