Despite hemodynamic stability in some patients with ventricular tachycardia, incorrect or untimely diagnosis can be dangerous, if not fatal.
Keeping this in view, what is a wide complex tachycardia?
A wide complex tachycardia is defined as a rhythm disturbance with a rate greater than 100 beats/min and a QRS complex duration of 0.12 seconds or more in the adult patient.
Additionally, is wide complex tachycardia the same as ventricular tachycardia? A wide complex tachycardia that is regular could be Vtach, SVT with aberrancy, pre-excited tachycardia or a v-paced rhythm. A wide complex tachycardia that is irregular may be atrial fibrillation with aberrancy, pre-excited atrial fibrillation, polymorphic vtach or torsades de pointes.
Considering this, what is the treatment for wide complex tachycardia?
Adenosine can be used initially for stable regular wide complex tachycardia. This is because a WCT caused by SVT with aberrancy (and right ventricular outflow tract ventricular tachycardia) are responsive to adenosine. Synchronized Cardioversion is the preferred treatment for unstable WCT.
Is Broad complex tachycardia dangerous?
Any irregular and sustained broad complex tachycardia should be assumed to be atrial fibrillation with either pre-existing bundle branch block or aberrant conduction (see Figure 10). It is rare for such a rhythm to be ventricular in origin. Although polymorphic VT is irregular, it is rarely sustained.
17 Related Question Answers Found
How is wide complex tachycardia measured?
Measure the QT interval by counting the number of small boxes between the start of the QRS complex and the end of the T wave. Multiply by 0.04 seconds: 8 × 0.04 = 0.32 seconds. The QT interval in this rhythm is normal (< 0.45 seconds). Repeat with at least 2 additional randomly selected QT complexes.
What causes wide complex tachycardia?
In polymorphic wide-complex tachycardia, the QT interval has to be analysed firstly. Torsade des pointes tachycardia results from QT interval prolongation and originates from inherited long QT syndrome, drugs, intoxication or electrolyte imbalance, to name the most common causes.
What is the drug of choice for ventricular tachycardia?
For the emergency treatment of sustained, hemodynamically stable ventricular tachycardia, antiarrhythmic drugs are the therapy of choice. Mostly class I antiarrhythmic drugs, such as lidocaine or ajmaline, are preferred.
What does a wide QRS complex indicate?
A “wide QRS complex” refers to a QRS complex duration ≥120 ms. Widening of the QRS complex is related to slower spread of ventricular depolarization, either due to disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization.
When would the duration of the QRS complex be considered abnormally long and what conditions would cause it?
Duration of an abnormal QRS complex is greater than 0.12 seconds. Shape of an abnormal QRS complex varies from almost normal to wide and bizarre and/or slurred and notched. Tall QRS complexes are usually caused by hypertrophy of one or both ventricles, or by an abnormal pacemaker or aberrantly conducted beat.
Is V tach a wide complex tachycardia?
Ventricular tachycardia refers to a wide QRS complex heart rhythm — that is, a QRS duration beyond 120 milliseconds — originating in the ventricles at a rate of greater than 100 beats per minute. This can be hemodynamically unstable, causing severe hypotension, and can thus be life-threatening.
What conditions are typically associated with wide QRS complexes?
Broad/Wide QRS Complexes Bundle branch block (RBBB or LBBB) Hyperkalaemia. Poisoning with sodium-channel blocking agents (e.g. tricyclic antidepressants) Pre-excitation (i.e. Wolff-Parkinson-White syndrome) Ventricular pacing. Hypothermia. Intermittent aberrancy (e.g. rate-related aberrancy)
What is a narrow complex tachycardia?
Narrow Complex Tachycardia – Approach. Narrow complex tachycardias are Supraventricular tachycardias, meaning only that they originate above the ventricles. Approach to sinus tachycardia: Arises almost always as a physiologic response or compensation to an underlying trigger, and this must be identified.
What medication should not be given when treating wide complex tachycardia?
Calcium channel blockers (Diltiazem and verapamil) are strongly advised not to be used for fear of hemodynamic collapse, hypotension and cardiac arrest [4].
Which drugs should be avoided in patients with irregular wide complex tachycardia?
Patient’s rhythm has wide (> 0.12) QRS complex AND Patient’s rhythm is irregular. Seek expert consultation. Avoid AV nodal blocking agents such as adenosine, digoxin, diltiazem, verapamil. Consider amiodarone 150 mg IV over 10 min.
What causes narrow complex tachycardia?
Atrial tachycardia is usually a narrow complex tachyarrhythmia accounting for 5-15% of supraventricular tachycardias (SVTs). The causes of atrial tachycardia include digoxin toxicity, coronary heart disease, cardiomyopathy, rheumatic heart disease and sick sinus syndrome.
How is unstable tachycardia treated?
Unstable patients with tachycardia should be treated with synchronized cardioversion as soon as possible. Stable patients with tachycardia with a palpable pulse can be treated with more conservative measures first.
How do you manage tachycardia?
An implantable device, such as a pacemaker or implantable cardioverter-defibrillator (ICD) may be used to treat some types of tachycardia. With the following treatments, it may be possible to prevent or manage episodes of tachycardia. Catheter ablation. Medications. Pacemaker. Implantable cardioverter. Surgery.
What is the most common cause of ventricular tachycardia?
But in most cases ventricular tachycardia is caused by heart disease, such as a previous heart attack, a congenital heart defect, hypertrophic or dilated cardiomyopathy, or myocarditis. Sometimes ventricular tachycardia occurs after heart surgery.
At what heart rate does tachycardia usually become symptomatic?
Generally, a heart rate between 100 bpm and approximately 150 bpm is usually caused by an underlying process that is represented as sinus tachycardia (see Stable Tachycardia module for more information on sinus tachycardia). Heart rates > 150 bpm may be symptomatic.
What is the best treatment for ventricular tachycardia?
Cardioversion is performed in a hospital setting using a cardioversion machine that monitors your heart rhythm before and after shocks are delivered. An injection of an anti-arrhythmic medication, such as lidocaine, may also be used to treat sustained ventricular tachycardia and restore a normal heart rhythm.
Can stress cause ventricular tachycardia?
Emotional stressors can lead to ventricular ectopic beats and ventricular tachycardia. Though disturbances of cardiac rhythm due to emotional stress are often transient, sometimes the consequences can be seriously damaging and even fatal [11]. Sudden emotional arousal can even trigger malignant ventricular arrhythmias.