Ventricular tachycardia

A 16-week pregnant woman presented with palpitations.

She had palpitations for 1 month. Echocardiography showed left ventricular systolic dysfunction. EF 40%. Left ventricular wall thickness was normal, LV diameters were slightly dilated. What is your diagnosis according to ECG?

This ECG shows;

1. wide QRS tachycardia with ventricular rate of 110/min

2. If we look closely at V1, there is a positive P wave after each QRS.

3. R to S >100 msec in precordial leads–> VT

4. aVR starts with q and duration >40 msec–> VT

5. In limb leads, II, III and aVF are positive, while I, aVL and aVR are negative. According to the limb lead criteria, this is also in favor of VT. Electrophysiology was performed non-flouro in this patient and the diagnosis of VT was confirmed. 3D mapping showed prepotentials in the left coronary cusp. With the application of RF to this area, VT was terminated within a few seconds. Left ventricular systolic dysfunction normalized during follow-up.