ECG of a patient shows >3 consecutive premature ventricular contractions (PVC) with a hea rate of less than 100 bpm. The diagnosis is?
First, the core concept is about arrhythmias. Specifically, distinguishing between different types based on ECG findings. PVCs in a row would suggest a regular rhythm. The key here is the number of PVCs and the rate. Three consecutive PVCs is a key point because that's how ventricular tachycardia is defined. But wait, ventricular tachycardia typically has a rate over 100 bpm. The question mentions the heart rate is less than 100. So maybe it's a non-sustained ventricular tachycardia? Or perhaps another diagnosis.
Wait, the question says "more than 3 consecutive PVCs" with a heart rate less than 100. Normally, ventricular tachycardia is defined as 3 or more consecutive PVCs at a rate over 100. So if the rate is under 100, maybe it's called accelerated idioventricular rhythm. That's a different entity. So the correct answer here should be accelerated idioventricular rhythm. Let me check that. Accelerated idioventricular rhythm has a rate of 50-110 bpm, but usually less than 100. So if the rate is under 100, that's the diagnosis. So the core concept is differentiating between ventricular tachycardia and accelerated idioventricular rhythm based on rate and morphology.
Now, the wrong options would be other arrhythmias. Let's think of the options. The user's correct answer is probably C or D, but since the options aren't given, I need to infer. The possible incorrect options could be atrial fibrillation, sinus tachycardia, ventricular fibrillation, or supraventricular tachycardia. But the question mentions PVCs, so supraventricular is less likely. So the key is the rate and the number of consecutive PVCs.
So the correct answer is accelerated idioventricular rhythm. The clinical pearl here is that sustained vs. non-sustained depends on the duration, but the rate is a key differentiator. For the explanation, I need to outline why the correct answer is right, why others are wrong, and provide a high-yield fact.
**Core Concept**
The question tests recognition of arrhythmias based on ECG criteria. **Ventricular tachycardia** is defined as ≥3 consecutive PVCs at a rate ≥100 bpm, while **accelerated idioventricular rhythm (AIVR)** occurs at a slower rate (50–110 bpm) with the same morphology. The distinction hinges on heart rate and clinical context.
**Why the Correct Answer is Right**
The patient has **>3 consecutive PVCs** with a **heart rate <100 bpm**, which aligns with **accelerated