What is the most appropriate therapy for a patient with ventricular tachycardia and low blood pressure?

In the context of a patient presenting with ventricular tachycardia (VT) and low blood pressure, synchronized cardioversion is the most appropriate therapy. This is because synchronized cardioversion is the preferred treatment for hemodynamically unstable arrhythmias, including VT, especially when the patient exhibits signs of deteriorating perfusion or shock, which are indicated by low blood pressure.

Synchronized cardioversion delivers a controlled electrical shock that is timed to occur during the R wave of the QRS complex. This timing minimizes the risk of inducing ventricular fibrillation or exacerbating the arrhythmia, making it safer for patients in a critical state. The goal of the procedure is to restore a normal heart rhythm and improve hemodynamics quickly, which is crucial for patients with low blood pressure.

The other options may not be appropriate in this scenario. While procainamide and amiodarone are antiarrhythmic drugs that can be used to treat stable VT, they may not be effective or appropriate for patients who are unstable with low blood pressure. Electrical defibrillation is generally indicated for pulseless VT or ventricular fibrillation rather than in the presence of a pulse, as in cases of VT with hemodynamic instability warranting cardi