V Tach Mimics
                                =============

þ "Slow V.Tach."
 - Ventricular tachycardia: ventricular rhythm with rate > 120 BPM 
 - Beware the diagnosis of VT in the patient with heart rate < 120 BPM!! 
   If HR< 120, consider 
  + Hyperkalemia 
  + Type lA medication toxicity TCA toxicity 
  + Cocaine toxicity Reperfusion arrhythmia 
    (accelerated idioventricular rhythm, AP AlVR) 
 - Treatment of these arrhythmias with traditional medications (lidocaine, amiodarone, 
   etc.) may induce asystole 
 - [McLean, et al (Ann Emerg Med, 2000)]
  + 2 cases of WCT due to hyperkalemia misdiagnosed as VT 
  + Treatment with lidocaine induced asystole 
  + Hyperkalemia potentiates the sodium channel blocking effect of lidocaine 
    induces severe conduction disturbance and asystole 
 - Treatment of post-thrombolytic AIVR with lidocaine (and other 
   antiarrhythmics?) may also induce asystole 
 - Safest treatment, when in doubt, is sodium bicarbonate or 
   electncal cardioversion