Ventricular tachycardia (VT) — an educational nurse reference.
The wide-complex, fast, regular rhythm you never want to sit on — and why any wide-complex tach is VT until proven otherwise.
Recognizing this rhythm at the bedside means matching pattern, intervals, and clinical context. This page covers the educational pattern; calipers and your clinical judgment carry it across the line.
What RN PocketPal does
Identifying traits
- Rate: typically 100–250 bpm.
- Rhythm: usually regular (monomorphic); polymorphic VT varies beat to beat.
- QRS: wide (> 0.12 sec), bizarre morphology.
- P waves: usually not visible (AV dissociation may be present).
- Monomorphic vs polymorphic: uniform QRS vs shifting axis (e.g., torsades).
Verify with
- Pulse check first — pulseless VT is a shockable arrest rhythm; follow ACLS.
- A wide-complex regular tachycardia is VT until proven otherwise — do not assume SVT with aberrancy.
- The code team, ACLS algorithm, and 12-lead — not an app — drive management.
Who it’s for
For Nurses and nursing students learning rhythm interpretation.
We publish a real ten-second recording on a rhythm reference only where we hold one under an open licence, rather than illustrating the pattern with a drawing. This rhythm does not have one yet — the identifying traits above are the reference until it does.
Rhythms this gets confused with
Known-answer practice — RN PocketPal does not interpret your patient's monitor. To work through strips with the answer revealed after you commit, open Rhythm Practice.
Frequently asked questions
- What's the first thing to check with VT?
- Whether the patient has a pulse. Pulseless VT is a cardiac-arrest, shockable rhythm — start CPR and follow ACLS. VT with a pulse is still an emergency and follows the tachycardia algorithm.
- How do I tell VT from SVT with aberrancy?
- It's genuinely hard, which is why the safe rule is: treat any wide-complex regular tachycardia as VT until a clinician proves otherwise. Misclassifying VT as SVT is dangerous.
- What is torsades de pointes?
- A polymorphic VT with a twisting QRS axis, classically associated with a prolonged QT. It's managed differently (often magnesium) and requires immediate clinician involvement.
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Reviewed by RN PocketPal Clinical Team, RN. Last reviewed .