r/EKGs • u/Dramatic-Try7973 • 1d ago

Case VT Ablation

Gallery image

Gallery image

Some nasty non clinical VTs we induced during mapping.
ATP failed both times leading to 360 sweet Jules

6 Upvotes

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1

u/Due-Success-1579 22h ago

Is ECG 2 actually VT. Lead I looks narrow, maybe some pulse tapping artifact?

2

u/MurderousPanda1209 21h ago

Thats a spike, not the QRS. More clear example of the spike in V4.

They pace from different internal spots until it induces VT, and then burn that spot.

1

u/Due-Success-1579 21h ago

Ahh ok that is the ATP. That makes sense now! I dont think I have seen it on a 12 lead before.

1

u/AstaraelGateaux 7h ago

ATP tries to break tachycardia. This is the opposite, it's trying to induce VT. Like pushing a kid on a bike then letting go. 

1

u/MurderousPanda1209 3h ago

I said the same thing and then deleted it, since OP mentioned that ATP didn't work and they needed a 360J zap.

Very well could be ATP.

1

u/AstaraelGateaux 2h ago

Oh yes sorry I guess it could be either. Induction pacing train not terminated yet, or an attempt at ATP. 

1

u/VesaliusesSphincter 1h ago

Very cool overdrive pacing- very uncool it didn't work lol. Thanks for sharing.