Summary

We present a patient who had a wide QRS tachycardia; it was initially difficult to determine whether it was superventricular tachycardia (SVT) or ventricular tachycardia (VT). By some criteria (sinus capture beats, pseudo-δ waves and wide QRS) the patient's ECG was suggestive of VT of epicardial origin. On the coronary angiogram it was found that this patient had significant coronary artery disease. He was stented with three stents and later had a full electrophysiological study .We present here the ECGs and the differential diagnosis and a brief review of the diagnostic features of epicardial VT.