Sustained V tach

[VFlutter]

I know this may not seem that impressive to some however this is the first time I have seen it in person. The patient was put on telemetry monitor two days ago and was A flutter 50-60s with rare PVC's. Last night they started to have frequent ectopy with couplets and triplets which progressed into non sustained runs of V tach. I came back on shift tonight and was told they were having sustained runs for approx 15 mins. About an hour into my shift they went into a sustained run of V tach 140s and have yet to convert back. Pt is a code II so they are not being too aggressive with it, they maxed out the amnio/lidocaine. They are not planning on cardioverting them. They have been in V tach for 4 and a half hours as of right now with the rate not dropping below 130, they have been asympotamic the entire time. It's pretty impressive what the human body can do and how different the real world is from the textbooks. Just thought I would share.




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[tssemt2010]

i have heard about it but never seen it, typically people can sustain vtac but unfortunately it usually doesnt last long, one of my co workers had a guy sustain vtac for about 30 minutes and was shocked about 12 times and still never converted. this is why i love the medical field, you will always see something that will blow your mind

 

[STXmedic]

I had a guy a few weeks ago that would keep going into 1-2min runs of VT, then convert back on its own. No Hx, no pacemaker/defib, asymptotic. h34r:

 

[VFlutter]

They ended up sustaining V tach for just over 6 hours before they had a brief run of A flutter for about 3 mins then back into V tach. Out of last 8 hours of my shift they couldn't have been in A flutter for more that 30 mins total.

 

[tssemt2010]

I had a guy a few weeks ago that would keep going into 1-2min runs of VT, then convert back on its own. No Hx, no pacemaker/defib, asymptotic. h34r:

had a patient do the same thing the other day, went from sinus tach to v-tach, didnt feel a thing lol

 

[VFlutter]

I have limited patient info but I do know they were on our cancer floor and waiting to be transferred to hospice so I am assuming they had a terminal cancer and would most likely have been on pain medication so I wonder how alert the patient actually was. Just a guess.

 

[Akulahawk]

I've seen a patient that was in a sustained VT for >2 hours. I transported that one... Other than the fast rate, there was very little remarkable about her presentation. Her heart was kicking along at 159-160 (very, very regular) for that long. She was ultimately cardioverted into a sinus brady at 25... It was about 8 years ago and I no longer recall the drug that was given (I didn't push it) that broke the VT and cardioverted her to SB.

That was kind of an interesting case. Among the history was that of AFib, on Dig and compliant with her meds.