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.

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.

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 June 4, 2026.