This 35-year-old woman presents to the ED with a one hour episode of palpitations. She reports that over the past two years, she has experienced biweekly intermittent palpitations lasting 10-15 seconds, that are occasionally associated with near-syncope. Otherwise, she is active and has no other medical conditions:

• Ventricular Tachycardia

Wide QRS tachycardia with inferior axis, and left bundle branch block morphology in the chest leads, compatible with Right Ventricular Outflow Tachycardia (RVOT). RVOT is the most common form of idiopathic VT.

After the injection of IV verapamil, her symptoms resolved and the following ECG was recorded:

• Sinus rhythm
• Left posterior fascicular block

A cardiac MRI was obtained to rule our ARVC (Arrhythmogenic Right Ventricular Cardiomyopathy). There was mild focal dyskinesis in the outflow tract of the right ventricle. EP studies were carried out, and ventricular tachycardia was induced by stimulation of the right ventricular outflow tract, with a morphology identical to that of the spontaneous VT. Ablation was successfully performed, and the arrhythmia could no longer be induced. Since then, the patient has had no further episodes of palpitations, and remains active and in good health.