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What’s this ECG showing?

A 45-year-old man with a history of unspecified intermittent arrhythmia presents with palpitations and dizziness.

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<p>A 45-year-old man with a history of unspecified intermittent arrhythmia presents with palpitations and dizziness.</p><p>He is conscious with systolic blood pressure of 90mmHg and a heart rate of 180-220 bpm. The remaining physical examination is unremarkable.</p><p>His initial ECG is pictured.</p><p><a target="_blank" rel="noopener noreferrer nofollow" href="https://images.media.ausdoc.com.au/wp-content/uploads/2026/01/06124453/Spot-Dx-Whats-this-ECG-showing.jpg">View an expanded version of the ECG here.</a></p>

Source: Oliveira CC, Rocha S, Magalhães S Wide QRS arrhythmia: what is the diagnosis? Reproduced from Emergency Medicine Journal, Vol. 39, Pages 99-158, 2022 with permission from BMJ Publishing Group Ltd.

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