4th May 2025

A 75-year-old woman with a history of type 2 diabetes mellitus and ischaemic heart disease is 3 days post hemicolectomy.

A 75-year-old woman with a history of type 2 diabetes mellitus and ischaemic heart disease is 3 days post hemicolectomy. She now complains of chest pain and breathlessness. The surgical team has asked for an urgent review.

On review, she looks unwell. Initial observations show a heart rate of 210 bpm and a blood pressure of 70/40mmHg. Peripherally she is shocked with a capillary refill time of 4 seconds. She has crackles bibasally on her chest.

12 lead-ECG shows broad based complex tachycardia with a monomorphic waveform.

Given her most likely rhythm, what is the next appropriate therapy in this case?

Select the SINGLE most appropriate option from the list below. Select ONE option only.