The picture shows monomorphic ventricular tachycardia (VT) where the QRS deflection (> 160 ms) is clearly different from typical bundle branch block. P waves have their own pace, i.e. the so-called VA dissociation (D) is depicted. In the midst of the broad complex tachycardia, a single fusion beat (F) is also detected. Precordial leads show concordance, i.e. all QRS deflections are in the same direction (C). These findings are diagnostic of VT but unfortunately not always identifiable.