Do I have VT or SVT?

My ECG can be seen here: http://128.121.99.94/ecg.jpg

(If the link above is not clickable please copy/paste the text starting from http and ending with jpg)

I am trying to educate myself as much as possible so that I can ask the right questions when I seen the cardiologist. I have been told this graph shows a Wide Complex Tachycardia. This could be VT or SVT with aberrancy. I have been reading up on it. As I understand, the distinction is critical because VT is life-threatening, while SVT is much less so.

Is it possible to tell from the ECG whether what I have is VT or SVT? If so what is the degree of certainty? What additional tests are needed, if any, to increase the degree of certainty? Will this additional test have to induce a tachycardia (VT or SVT) to happen in order to make a determination, and if so is there a risk of a heart attack or stroke during the test?

What specific features of my ECG are indicative of VT or SVT? (For example, in V1 the right peak is taller than the left peak, does that mean anything?)

During the treadmill test I had no chest pain, and the notes say that "no ischemic changes were noted". I did feel faint for a couple of seconds after the test, but I am guessing that could be because the treadmill exercise was stopped abruptly (when they noticed WCT) without a cool-down.

I am a 41 year old male, and as far as symptoms, I have not had any shortness of breath, dizziness or lightheadedness, no fainting or blackout. The symptoms I do have, I am told are not cardiac related: mild chest pain in left side of chest, lasting a few seconds, and occurring a few times a day. This has been going on for a month. I am told this is not angina. I have also noticed loss of sensitivity, lasting a few minutes, once on my chin, twice in my right thigh. I haven't been given a diagnosis for the chest pain or the paresthesia.

[Michael J. McWilliams, M.D.]

I can't look at the EKG and read it.  The site is for informational purposes only and I cannot help make medical decisions.  Complex EKGs for VT/SVT often take 10-15 minutes to analyze.

Distinguishing between VT and SVT on EKGs is often very difficult.  When I present this topic to medical residents, it is often met with glassy eyes.  The best thing to do is talk to a heart rhythm specialist to have him analyze the EKG and assess your risks.  This website goes through the criteria:

http://askdrwiki.com/mediawiki/index.php?title=Brugada_Criteria

It is very complicated to understand.

The first step in assessing risk is a detail history and physical and then appropriate tests.  Ruling out ischemia is important with a stress test.  An echocardiogram helps establish if you have a structurally normal heart.  Then the EKG is both resting and with the heart rhythm is important to analyze.

If you have normal studies, your risk of sudden death is very low.  Under some circumstances, an EP study is done to determine if it is SVT or VT.  SVT is often easily treated with an ablation.  If your cardiologist isn't sure, it might be worth seeing an electrophysiologist to see if further testing is appropriate.

I hope this helps.

[cardiopatient]

I wanted to add that I have elevated cholesterol (total = 230), bp is usually around 130/80. I don't have sleep apnea, I am not taking any medications, except I am taking aspirin after this started. I weigh 160 lbs and I am healthy except for this recent heart issue.

[PikaPika88]

Have you wear a 24 hours holter monitor yet?  I found an echocardiogram and holter quite interesting.  ECG just a second recording thing.  If your SVT/VT happens in next minutes then no one knows.

Unfortunatelly, my cardio don't believe any.  He sent me for the stress test.  He told me it was all attenuation artifacts.