Ventricular Escape Complex

In the absence of nodal activity, sinus node or AV node, the ventricles can serve as a backup pacemaker at the much reduced rate of 20-40/minute. These complexes occur after the expected QRS complex and are called ventricular escape complexes (VEC). This slower rate, while far better than asystole, rarely provides enough blood flow for the body. Signs and symptoms of shock are likely. The ventricles are considered an unreliable pacemaker, with the possibility of failure at any moment. The provision of an electronic pacemaker – temporary, transvenous, or permanent is often required.

Successive ventricular complexes are called a ventricular escape rhythm, idioventricular rhythm, or simply a ventricular rhythm. Don’t forget to tack on a heart rate to the rhythm name to help establish the possible clinical impact.

sinus arrhythmia, HR 60/min, ST elev, non-conducted PAC, VEC and movement artifact

1. Six Second ECG Guidebook (2012), T Barill, p. 116, 208

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