How does ventricular tachycardia typically appear on an EKG?

Ventricular tachycardia (VT) is characterized by a specific pattern on an EKG that reflects the rapid electrical activity originating in the ventricles. It typically presents with wide, bizarre QRS complexes at a fast rate, often exceeding 100 beats per minute. The QRS complexes in VT appear widened because they result from abnormal conduction within the ventricles rather than the normal conduction system. This altered conduction is what leads to the "bizarre" appearance, distinguishing it from other forms of tachycardia that might not originate from the ventricles.

A common misconception is equating rapid heart rates with narrow QRS complexes, which are usually seen in supraventricular tachycardias where the electrical impulses are still being conducted through the normal pathways. However, in VT, the mechanical inefficiency of the ventricles contributes to the wide QRS morphology and demonstrates the significant difference between ventricular and supraventricular rhythms. The identification of these complex features on the EKG is crucial for appropriate diagnosis and management in a clinical setting.