Cardiac Electrophysiology And Heart Failure Practice Test

When ventricular tachycardia causes hemodynamic instability, the priority is to rapidly restore perfusion with electrical therapy. If the patient has a pulse, deliver a synchronized cardioversion immediately. Synchronization times the shock with the QRS complex, delivering energy when the ventricles are ready to respond and avoiding on-the-T-wave shocks that could worsen the rhythm. This approach quickly terminates the tachycardia and improves circulation. Vagal maneuvers won’t reliably convert VT and aren’t appropriate as the first step in unstable VT. Antiarrhythmic drugs are important, but they’re adjuncts after stabilization rather than the initial move. If there were no pulse, the protocol would shift to immediate unsynchronized defibrillation, but in this unstable VT with a pulse, synchronized cardioversion is the best initial action.