A change in rhythm can be either abrupt (e.g. sudden onset SVT) or gradual (e.g. slowing of rate between sinus tachycardia and normal sinus rhythm).See also: Other Rhythms
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This ECG is from a man in his 60s who presented with abdominal pain dyspnoea and altered level of consciousness, in shock.
This ECG shows wide complex tachycardia with concordant ST elevation in V4-6, due to LAD occlusion. The rhythm was likely sinus tachycardia with RBBB and then LAFB mid way through the trace.