Broad complex tachycardia in female ?Diagnostic dilemma

A 37 year old female came to JIPMER cardiology OPD with chief complaints of two episode of  palpitation over last one year. Patient went to private hospital and DC cardioversion was done. Patient was a known case of diabetes mellitus since last one year and was on dietary management. Patient was also giving  history of inferior wall myocardial infarction in 2015, for which she was treated at private hospital with thrombolytic therapy with tenecteplase and was started on medical management.Patient was doing well till  she developed one episode of tachycardia in october 2016 for which she was cardioverted with DC shock and was started on medical management. But again on  november 2016(14/11/2016) she developed one episode of tachycardia for which she was DC cardioverted. Later patient underwent coronary angiography (15/11/2016) which was suggestive of spontaneous dissection of right coronary artery from proximal to mid part with right dominance, rest of the coronary artery were normal. Following this patient was  referred to JIPMER Hospital, Pondicherry for electrophysiology study and further management.During evaluation at JIPMER hospital patient Pulse was 54 beats per minute, blood pressure 110/70 mmhg, ECHO done which was suggestive of hypokinesia of inferior wall, inferoseptal, posterior wall with  moderate mitral regurgitation, LVEF was around 50%. 

Previous ECG of the patient during tachycardia is shown below(Click on the image to enlarge it)

ECG-Broad complex regular tachycardia with heart rate around 200 beats per minute, QRS duration around 200 msec, QRS morphology being RBBB,  right axis deviation,no obvious P wave seen. There were no capture beat,fusion beat, QR wave seen in lead V1, RS wave seen in lead V6 with R/S ration being less than one, large R wave seen in lead avR, so this is a broad complex regular tachycardia with differential diagnosis being First Ventricular tachycardia second being Supraventricular tachycardia with aberrancy.

Another ECG of the same patient during tachycardia

ECG is suggestive of broad complex regular tachycardia with RBBB morphology with right axis deviation.

ECG of patient during sinus rhythm

ECG Normal sinus rhythm at 50 beats per minute, normal axis, QS complex in lead II,III,avF, no other ST-T wave changes seen.

So in view of baseline ecg suggestive of narrow QRS complex with past history of myocardial infarction patient ecg diagnosis being ventricular tachycardia. Patient underwent electrophysiology study followed by CARTO guided ventricular tachycardia ablation at JIPMER cardiology department by Dr Raja Selvaraj successfully. Presently patient is planned for OCT guided PCI to RCA in view of her coronary angiography suggestive of RCA dissection.

Now lets discuss how to approach in a patient with broad complex tachycardia. Kindly see the flow diagram given below. (Click on the image to enlarge it)

Thank you.