Ventricular tachycardia with positive concordance

Monophasic R waves are noted in all the precordial leads; this is positive concordance. Dissociated P waves are evident in the lead II rhythm strip and in lead aVR. Thick arrow shows artifact. Arrowheads show P waves, marching out at approximately 54 beats per minute. P waves are less evident on the left side of the lead II rhythm strip.