How to recognize ventricular tachycardia and fibrillation
Other platforms explain it with text and video. In VMS you practice it on the patient.
Ventricular tachycardia and fibrillation are the rhythms most often fixed by an early shock. Recognizing them and checking the patient in seconds saves lives.
Step by step
Check the patient first
Look for responsiveness, breathing and a pulse. Loose leads or movement can look like a lethal rhythm. [1]
Recognize VT
VT is a run of wide QRS complexes (0.12 seconds or more), usually regular, at over 100 per minute. Treat any wide, regular, fast rhythm as VT until proven otherwise. [2]
Recognize VF
VF is a chaotic, irregular wavy line with no clear QRS complexes. The patient has no pulse. [2]
Spot torsades
Polymorphic VT that twists around the baseline, often with a long QT, is torsades de pointes. It is treated with IV magnesium. [2]
No pulse: CPR and shock
Start high-quality CPR and defibrillate as soon as the defibrillator is ready. Resume CPR right after each shock. [1]
Pulse but unstable: cardiovert
VT with a pulse and low blood pressure, confusion or chest pain needs synchronized cardioversion. [1]
Pulse and stable: get help
Record a 12-lead ECG, prepare antiarrhythmic drugs per protocol and get expert help. [1]
Common errors
- Treating the monitor and not checking the patient.
- Assuming a wide fast rhythm is SVT and giving the wrong drug.
- Delaying the first shock in pulseless VT or VF.
Practice it in VMS
In VMS you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.
VMS cases that train this skill
Sources
- AHA Guidelines for CPR and ECC
- NCCPA PANCE Content Blueprint
- AAMC Core Entrustable Professional Activities (Core EPAs)
Facts and steps follow AAMC Core Entrustable Professional Activities (Core EPAs); NCCPA PANCE Content Blueprint. VMS is not affiliated with these organizations. Updated: 2026-10-11.