No P waves are seen in this wide-wide tachycardia. The overall morphology is like LBBB. This is an example of V.T. demonstrating Josephsons criteria. Dr. Mark Josephson identified distinctive features in patients with wide-QRS tachycardia resembling LBBB. There are three features in V1 that allow a judgement. They are shown above and are present in is this tracing. A = fat initial R wave >.03 sec. B = slurred and notched downslope C = the nadir of the S wave is far removed from the onset of the QRS complex. Dx: ventricular tachycardia.